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

3. 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

5. 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

7. 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.

9. 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.).

11. 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.