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Report (Tuberculosis)

Report (Tuberculosis)

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Published by Angelo Mangibn

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Published by: Angelo Mangibn on Aug 20, 2008
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ANGELES UNIVERSITY FOUNDATIONCollege of NursingAngeles CityRelated Learning ExperienceRafael Lazatin Memorial Medical CenterOPD
Tuberculosis
A Report
In Partial Fulfillment of the Requirements in the courseBACHELOR OF SCIENCE IN NURSINGSubmitted to
Ian Frederick S. Fernandez RN
Submitted by:
Rei Angelo P. Mangibin
BSN III-14 (Group 55)
 
Tuberculosis
(abbreviated as
TB
for 
tubercle bacillus
or 
T
u
b
erculosis) is a common anddeadlyinfectious diseasecaused bymycobacteria, mainly
.Tuberculosis most commonly attacks the lungs (as pulmonaryTB) but can also affect thecentral  nervous system, thelymphatic system, thecirculatory system, thegenitourinary system, bones,  jointsand even theskin. Other mycobacteria such as
, 
,
, and
can also cause tuberculosis, butthese species do not usually infect healthy adults.One-third of theworld's current populationhas been infected by TB, and new infectionsoccur at a rate of one per second.
 
 Not everyone infected develops the full-blown disease;asymptomatic,latent infection is most common. However, one in ten latent infections will progress to active disease, which, if left untreated, kills more than half of its victims.In 2004, mortality and morbidity statistics included 14.6 million chronic active cases, 8.9 millionnew cases, and 1.6 million deaths, mostly indeveloping countries.In addition, a rising number of  people in thedeveloped worldare contracting tuberculosis because their immune systemsare compromised byimmunosuppressive drugs,substance abuse, or HIV/AIDS. The rise in HIV infections and the neglect of TB control programs have enabled aresurgence of tuberculosis. The emergence of drug-resistantstrains has also contributed to thisnew epidemic with, from 2000 to 2004, 20% of TB cases being resistant to standard treatmentsand 2% resistant tosecond-line drugs. TB incidence varies widely, even in neighboringcountries, apparently because of differences in health care systems. TheWorld Health Organizationdeclared TB a global health emergency in 1993, and the Stop TB Partnershipdeveloped aGlobal Plan to Stop Tuberculosisthat aims to save 14 million lives between 2006and 2015.
Symptoms
When the disease becomes active, 75% of the cases are pulmonaryTB. Symptomsinclude chest pain,coughing up blood, and a productive, prolonged cough for more than threeweeks. Systemic symptoms include fever, chills,night sweats, appetite loss, weight loss, pallor, and often a tendency to fatigue very easily.In the other 25% of active cases, the infection moves from the lungs, causing other kindsof TB more common inimmunosuppressedpersons and young children. Extrapulmonaryinfection sites include thepleura, thecentral nervous systeminmeningitis, thelymphatic system  inscrofulaof the neck, thegenitourinary systemin urogenital tuberculosis, and bones and joints inPott's diseaseof the spine. An especially serious form is disseminated TB, more commonlyknown asmiliary tuberculosis. Although extrapulmonary TB is not contagious, it may co-existwith pulmonary TB, which
is
contagious.Bacterial species
 
Scanning electron micrograph of Mycobacterium tuberculosis
The primary cause of TB ,
, is anaerobic  bacteriumthat dividesevery 16 to 20 hours, an extremely slow rate compared with other bacteria, which usuallydivide in less than an hour. (For example, one of the fastest-growing bacteria is a strain of 
that can divide roughly every 20 minutes.) Since MTB has a cell wall but lacks a phospholipid outer membrane, it isclassifiedas aGram-positivebacterium. However, if aGram stainis  performed, MTB either stains very weakly Gram-positive or does not retain dye due to the highlipid & mycolic acid content of its cell wall. MTB is a small rod-like bacillusthat can withstandweak disinfectantsand survive in adry statefor weeks. In nature, the bacterium can grow only within the cells of ahostorganism, but
M. tuberculosis
can be cultured
.Usinghistologicalstains on expectorate samples fromphlegm(also called sputum), scientists can identify MTB under a regular microscope. Since MTB retains certain stains after  being treated with acidic solution, it is classified as anacid-fast bacillus(AFB). The mostcommon staining technique, theZiehl-Neelsen stain, dyes AFBs a bright red that stands outclearly against a blue background. Other ways to visualize AFBs include anauramine-rhodamine stainandfluorescent microscopy.The
M. tuberculosis
complex includes 3 other TB-causingmycobacteria: 
,
and 
. The first two only very rarely cause disease inimmunocompetent  people. On the other hand, although
M. microti
is not usually pathogenic, it is possible that the prevalenceof 
M. microti
infections has been underestimated.Other known pathogenicmycobacteriainclude
,
and
M. kansasii
. The last two are part of thenontuberculous mycobacteria(NTM) group. Nontuberculous mycobacteria cause neither TB nor leprosy,but they
do
cause pulmonarydiseases resembling TB.
 Transmission
When people suffering from active pulmonary TB cough, sneeze, speak, kiss, or spit,they expel infectiousaerosoldroplets 0.5 to 5µmin diameter. A single sneeze, for instance, can release up to 40,000 droplets. Each one of these droplets may transmit the disease, since theinfectious dose of tuberculosis is very low and the inhalation of just a single bacterium can causea new infection.

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