1. INFECTIOUS BACTERIAL AIRBORNE DISEASES PULMONARY TUBERCULOSIS

2. INTRODUCTION
Pulmonary Tuberculosis (TB) is an infectious disease that mainly affect the lungs parenchyma. but may spread to other organs.
TB is an ancient disease. Signs of skeletal TB (pott disease) were evident in Europe, ancient egypt, and in the pre-Columbian New World.
Physicians in ancient Greece called this illness as “phthisis” reflecting its wasting character.

3. The main cause of TB is Mycobacterium tuberculosis or Tubercule bacilli.
a small, aerobic, nonmotile bacillus. It divides every 16 to 20 hours, which is an extremely slow rate compared with other bacteria, which usually divide in less than an hour.
Mycobacteria have an outer membrane with high lipid bilayer and high mycolic acid content which makes cells impervious to Gram staining. So, the cells can stained with Acid Fast Stain (Ziehl–Neelsen stain) that gives the bacterium a red color.
MTB can withstand weak disinfectants and survive in a dry state for weeks. In nature, the bacterium can grow only within the cells of a host organism, but M. tuberculosis can be cultured in the laboratory.
ETIOLOGY

4. Other than M. tuberculosis that caused tubercolosis in Human– includes;
M. avium intracellulare
M. kansasi
M. scrofulaceuru
M. ulcerans
M. marinum and etc.

5. Risk factors of tuberculosis is;
Elderly
Infants
Low socioeconomic status
Crowded living conditions
Disease that weakens immune system like HIV
Alcoholism

6. If not treated properly, TB can be fatal.
Transmission Methods
TB spread from person to person by airborne transmission. Infected person release droplet nuclei (1-5 micro meter in diameter) through,
Talking
Coughing
Sneezing
Laughing
Singing
If not treated properly, TB can be fatal.

7. Inside The Lung
Breath in infected air and bacilli go to lungs through bronchioles
Bacilli infect alveoli
Macrophages attack bacteria, but some survive
Infected macrophages separate and form tubercles
Dead cell form granulomas

9. PATHOGENESIS Recovery Susceptible Or Latent Mycobacterium Tuberculosis
Infection
Reactivation
PULMONARY
TUBERCULOSIS
Active
tuberculosis
Miliary
tuberculosis
Extrapulmonary
Tuberculosis

10. Tuberculosis (TB): Types
Tuberculosis (TB) may be regarded in two categories: active disease or latent infection. The most common form of active TB is lung disease, but it may invade other organs, so-called "extrapulmonary TB.“

11. Active TB Disease Active TB is an illness in which the TB bacteria are rapidly multiplying and invading different organs of the body. The typical symptoms of active TB variably include cough, phlegm, chest pain, weakness, weight loss, fever, chills and sweating at night. A person with active pulmonary TB disease may spread TB to others by airborne transmission of infectious particles coughed into the air.

12. Miliary TB Latent TB Infection
Miliary TB is a rare form of active disease that occurs when TB bacteria find their way into the bloodstream. In this form, the bacteria quickly spread all over the body in tiny nodules and affect multiple organs at once. This form of TB can be rapidly fatal.
Latent TB Infection
Many of those who are infected with TB do not develop overt disease. They have no symptoms and their chest x-ray may be normal. The only manifestation of this encounter may be reaction to the tuberculin skin test (TST) or interferon-gamma release assay (IGRA). However, there is an ongoing risk that the latent infection may escalate to active disease. The risk is increased by other illnesses such as HIV or medications which compromise the immune system.

13. MANIFESTATIONS-symptoms
The primary stage of TB usually doesn’t cause symptoms. When symptoms of TB occur, they may includes;
Fatigue
Fever
Unintentional weight loss

14. Breathing difficulty
Chest pain
Wheezing.
Cough up of mucus and blood
Excessive sweating at night.

15. SIGNIFICANT LAB TEST Tuberculin skin test
Injecting a small amount of protein from tuberculosis bacteria between the derived layer of the skin (usually forearm).
Sputum examination and Cultures
Is examined under a microscope to look for tuberculosis bacteria and used to grow the bacteria in a culture.

16. Interferon-gamma Blood test;
A simple blood is mixed with synthetic proteins similar to those produced by the tuberculosis bacteria.
If people are infected with tuberculosis bacteria, their white blood cells produce certain substances (interferons) in response to the synthetic proteins.

17. Imaging and Radiological Consideration
Chest CT Scan
Chest X-ray

18. Treatment
With tuberculosis, you must take antibiotics for at least six to nine months.
* The exact drugs and length of treatment depend on your age, overall health, possible drug resistance, the form of TB (latent or active) and the infection's location in the body.

19. Most common TB drugs
If one has latent tuberculosis, he may need to take just one type of TB drug.
Active tuberculosis, particularly if it's a drug-resistant strain, will require several drugs at once.
The most common medications used to treat tuberculosis include:
Isoniazid
Rifampin (Rifadin, Rimactane)
Ethambutol (Myambutol)
Pyrazinamide
If one has drug-resistant TB, a combination of antibiotics are generally used for 20 to 30 months.

20. Medication side effects. Nausea or vomiting. Loss of appetite
Medication side effects * Nausea or vomiting * Loss of appetite * A yellow color to your skin (jaundice) * Dark urine * A fever that lasts three or more days and has no obvious cause