TB PARU

Etiology
TB is caused by Mycobacterium tuberculosis, a slow-growing obligate aerobe and a facultative intracellular parasite. It retains many stains after decoloration with acid-alcohol, which is the basis of the acid-fast stains used for pathologic identification.

Infection with M tuberculosis results most commonly through exposure of the lungs or mucous membranes to infected aerosols. The lungs are the most common site for the development of TB; 85% of patients with TB present with pulmonary complaints.

 The

typical TB lesion is an epithelioid granuloma with central caseation necrosis. The most common site of the primary lesion is within alveolar macrophages in subpleural regions of the lung. Bacilli proliferate locally and spread through the lymphatics to a hilar node, forming the Ghon complex.

Signs and symptoms

Cough

Weight
Fever Night

loss/anorexia

sweats Hemoptysis Chest pain (can also result from tuberculous acute pericarditis) Fatigue

Primary Tuberculosis
First

infection with M. tuberculosis Primary or Ghon focus Lymphatic spread Hematogenous spread Development of delayed hypersensitivity and cell mediated immunity within 8 weeks

Primary Tuberculosis

Post primary or Reactivation Tuberculosis

Reactivation of previously dormant primary infection, tough in a small number of cases , it is extension of primary infection if it occurs within a year of initial infection. It is a disease of adolescent and adult It affect primarily the upper lobes with a propensity to cavitate Extrapulmonary site include the LN, pleura, bone, CNS, GU, Peritoneum

Post primary or Reactivation Tuberculosis

THANK YOU

Basil dalam droplet nuclei

TB PRIMER

Koloni di alveolus = Fokus Ghon

Difagosit makrofag

Fokus Ghon + Limfangitis + Limfadenitis = Kompleks Ghon/primer

spreading

Sembuh dengan cacat

Sembuh tanpa cacat

DORMAN

Perkoninuitatum ke jar sekitar, bronkogen, hematogen, limfogen

Fibrotik, kalsifikasi

TB POST PRIMER
Basil TB yang dorman

Reinfeksi

Reaktifasi

Pada daerah endemis TB / keluarga TB

Imunitas menurun

Pemeriksaan Radiologik

TB minimal lesion
Ringan-sedang

Lesi

terbatas s/d iga 2 depan ke atas Lesi soliter dpt berada dimana saja Kavitas (-)
Iga 2

Pemeriksaan Radiologik

moderate advanced tb
Sedang-

berat Lesi bisa terdapat pada 1 atau 2 paru tapi total lesi tidak > 1 lapang paru Kavitas (+) dg diameter tidak > 4 cm

Pemeriksaan Radiologik

far advanced tb
Lesi

melebihi klasifikasi minimal & moderate TB Kavitas > 4cm > 1 lapang paru

Gb. 2.31 TBC miliar Pr. 43 th. dgn. keluhan BB turun & keringat malam Nodul miliar tersebar dikedua paru

Gb. 2.36 Tuberculoma Nodul soliter lobus sup. kanan dgn. calsifikasi