TUBERCULOSIS Presentation: @ Pyrexia, fatigue, night sweats, weight

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Presentation transcript:

TUBERCULOSIS Presentation: @ Pyrexia, fatigue, night sweats, weight loss, cough, anorexia, haemoptysis. @ Lymph adenitis, infertility, arthritis , osteomyelitis, abscess, meningitis, miliary tuberculosis

Control Measures: @ BCG Vaccination: Live, attenuated strain of Myco. Bovis. Given I.D. and protection rate is 75% for 10 years. Gives protection against leprosy @ Isoniazid: given orally for 6-9 months. @ Pasteurization of milk, @ Slaughtering of infected cattle. @ Good housing conditions, Good nutrition

Tuberculin Skin Testing @ Mantoux test: # Given I.C. by a needle. Dose of 1-3 units of the P.P.D. of Myco. bovis. # Leave for 3 days & measure the induration and oedema formed at site. # Positive test: at least 10 mm diameter # Positive: person has a cell-mediated immunity against T.B. @Heaf Test: # As Mantoux, given by multiple puncture

Interpretation of Tuberculin Test @ Positive means: # Current or previous infection # Previous vaccination # Asymptomatic exposure to T.B. @ Negative means: # Not infected, no previous exposure # Very early infection # Immunosuppression # Miliary T.B.

Advantages of Tuberculin Testing @ Indicates T.B. control: when positive tests in children under 14 years are less than 1% @ Tracing open cases of T.B. in families. @ Indicates no T.B in children if negative @ Indicates early infection if it is highly positive (more than 15 mm.).

Tuberculosis Risk Groups: @ Immigrants, alcoholics, IV drug addicts @ Patients with liver cirrhosis, neoplasia, HIV, diabetes mellitus, pregnancy Treatment: @ Combination chemotherapy with rifampicin, isoniazid, pyrazinamide and ethambutol. @ Streptomycin is not used now.