TUBERCULOSIS

and
COVID19
Corda | Cebricus | Eder | Garong | Salado
 The Case of Mang Vic
Name:
Victor Magtanggol
What is your diagnosis?

Age: Chills
75 years old

Job: Hemoptysis
Fisherman

Chest pain
 The Case of Mang Vic

Started smoking Celebrated fiesta with Mang Mang Canor: COVID positive Mang Vic had chest pain and
Can finish 100 cigarettes Canor Mang Vic: on & off cough chills

14 years old Last week 4 days after 3 days after

Prior to checkup
 The Case of Mang Vic
BMI
Underweight

Chest Xray
• Trachea is midline
• Heart shadow is not enlarged
• Intact both diaphragm and
costophrenic angles
• Other chest structures normal,
however
• Reticulo-fibroid infiltrates are seen in
the upper lungs
 The Case of Mang Vic

Sputum What is your diagnosis?

COVID

Tuberculin
Skin Test
 TUBERCULOSIS
What is the global impact of tuberculosis?

2 Billion people
2B worldwide are infected

90 90 – 95%
% not aware that they are infected
TUBERCULOSIS
worldwide
4th
Tuberculosis incidence

1M have active TB

Filipinos die
70
every day

650 for every 100,000

infected with TB in 2021
TUBERCULOSIS: Pathogen
 TUBERCULOSIS: Pathogen

Rod-shaped Has mycolic acid

Stains red under the
Needs oxygen to survive
microscope

Wall is hardy Wall is hardy

Making it resistant to weak Survive in dry surfaces for
disinfectants months
 TUBERCULOSIS: Transmission
Tuberculosis infection: How does it spread?
Droplet
Airborne
nuclei
 TUBERCULOSIS: Transmission
Tuberculosis infection: How does it spread?
01 03
Environment Susceptibility
Closed space Immune status of the
No ventilation exposed individual

02 04
Infectiousness Exposure
Number of tubercle bacilli Proximity, exposure, and
expelled in the air duration of exposure
TUBERCULOSIS: Pathophysiology
TUBERCULOSIS: Pathophysiology

Caseous
Necrosis
TUBERCULOSIS: Pathophysiology
 TUBERCULOSIS: Pathophysiology

Ranke
Complex
characteristic consistent
with TB
 TUBERCULOSIS: Pathophysiology

90% 10%
Latent Primary
phase Progressive
TB is viable but goes if immune system is
dormant compromised
 TUBERCULOSIS: Pathophysiology
Upper lobes

More
caseous
necrosis

Cavitates

TB
disseminates
 TUBERCULOSIS: Pathophysiology

Pneumothorax Hemoptysis
Air goes out to the pleural Blood vessels destroyed
space by lesions

Necrotic tissues spread Increased vascular

and cause more pus & permeability so more fluid
fluid accumulation in the pleural space
Bronchopneumoni Pleural
a effusion
 TUBERCULOSIS: Pathophysiology

Productive cough Fever, night sweats, Weight loss

chills
Hyperinflammation of Stimulate hypothalamus
Stimulate hypothalamus that
respiratory structures that controls appetite
controls temperature
Post-Primary Tuberculosis

within first two years

HIV following the initial infection as a
contact to a person with
infectious TB
Diabetes

Malnutrition
Medications for rheumatoid
arthritis, steroids, or cancer
Immunosuppressants chemo

Aging
Primary vs Post-Primary TB

Primary Tuberculosis
Timing of onset:
when a person is first exposed to the
M. tuberculosis bacteria and develops
an initial infection

Reactivated/
Secondary TB
Timing of onset:
bacteria have been dormant and
becomes active again
 Extrapulmonary Tuberculosis

Central Nervous
Lymph nodes
System

Bone and joints Skin

Urinary tract GI Tract

 Extrapulmonary Tuberculosis

Lymph nodes
Extrapulmonary Tuberculosis

Bone and joints

Extrapulmonary Tuberculosis

Urinary tract
Extrapulmonary Tuberculosis

Central Nervous
System
Extrapulmonary Tuberculosis

GI Tract
Extrapulmonary Tuberculosis

Skin
 Tuberculosis: Symptoms
Coughin
Chest Fever Loss of
g up
pain Night sweats appetite
blood

01 02 03 04
 Tuberculosis: Symptoms

Shortness Swelling of
Fatigue
of breath lymph nodes

05 06 07
 Tuberculosis: Diagnosis

1 3
Chest xray Molecular
tests

Tuberculin Sputum
skin test culture
2 4
 Tuberculosis: Diagnosis

Tuberculin
skin test
Tuberculosis: Diagnosis

3
Chest xray

Sputum
culture
2
Tuberculosis: Diagnosis

Molecular
tests

4
 Tuberculosis: Treatment

Antibiotics Human stem cells Mesenchymal SC

Regulate inflammatory
Isoniazid Protective niche for
response and alleviate lung
Rifampin dormant M. Tuberculosis
injury of TB, affecting
Ethambutol having reactivation
survival of host cells and
Pyrazinamide potential
clearing bacteria
 What is COVID19?

March 11, 2020

WHO declared a pandemic

767,364,883
Confirmed cases as of
May 2023

6,938,353
Deaths as of May 2023
 What is COVID19?

Coronavirus 2 SARS-CoV-2
Belonging to family 1 2 Named as Severe Acute
Coronaviridae Resporatory Syndrome
Coronavirus-2

Outbreak in
Homologous to
Wuhan, China 4 3 SARS-Cov
Zoonotic spread from
seafood markets 2002-2003 period
COVID19: Pathogen
COVID19:
Pathogen

Host Cell Invasion

COVID19:
Pathogen

Figure:
The severe acute respiratory
syndrome coronavirus-2 life
cycle
COVID19: Transmission
COVID19: Transmission

>5-10 um Respiratory droplet

>5-10 um Droplet nucleus

Droplet Transmission
 a person is in in close contact (within 1 m)
conjunctiva (eyes) exposed to potentially
infective respiratory droplets
 through fomites in the immediate environment
around the infected person
COVID19: Transmission

Airborne transmission
presence of microbes within droplet
nuclei and can remain in the air for
long periods of time
COVID19: Transmission

Fluid transmission
via: feces, saliva, urine, semen,
and tears
COVID19: Transmission

Contact with infected

Through direct contact with someone who
has the virus, Mother to child
COVID19: Pathophysiology

Respiratory aerosols
binds to nasal epithelial cells in the
upper respiratory tract

Replication
virus replicates and spreads
locally, infecting ciliated cells in the
conducting airways
COVID19: Pathophysiology

Fever

Dry cough

Fatigue
Release of:
CXCL-10
Interferons
COVID19: Pathophysiology
1/5 of all patients Proceed to invasion of lower respiratory
tract and acquire severe symptoms
COVID19: Pathophysiology

Neutrophils
CD4 helper T cells
CD8 cytotoxic T cells

ARDS
 COVID19: Pathophysiology

Collapsed
alveoli

ARDS
 COVID19

5-6 days 14 days

Incubation Pre-
period symptomatic Infected people can be contagious
period
 COVID19 Symptoms

01 Fever Body pains 02

Shortness of Malaise 04
03 breath

Gastrointestinal
04 Dry cough Vomiting 06
Diarrhea
 COVID19: Diagnosis

1 3
Chest Rapid
CT scan Serological
Testing

Pneumorapid
RT-PCR
testing
2 4
 COVID19: Diagnosis

RT-PCR
 COVID19: Diagnosis

Chest
CT scan

2
COVID19: Diagnosis

Pneumorapid
testing
COVID19: Diagnosis

Rapid
Serological
Testing

4
 COVID19: Treatment

Isolation & Rest Fluids Ventilatory support

Individuals with mild

symptoms should Severe symptoms:
isolate themselves at supported care such as providing ill people
home to improve with with fluids, oxygen, and ventilatory support
rest and fluids
Tuberculosis vs COVID19

01 02

COVID19 Tuberculosis
• Airborne disease that
• A respiratory illness
usually attacks the lungs
caused by a virus that
but can also spread to other
spread from person to
parts
person
• Can be latent or active
• Symptoms may develop
• Symptoms may develop up
2-14 days after
to weeks or years
 Tuberculosis vs COVID19

Additional COVID19
Additional TB symptoms
symptoms

New loss of taste or smell Night sweats

Sore throat & congestion/runny nose Persistent chest pain

Nausea or vomiting Coughing up blood or phlegm

Muscle or body ache; diarrhea Weight loss or fatigue

 The Case of Mang Vic

Chills TUBERCULOSIS

Chest pain

Coughing of
blood

Reticulo-fibroid
On & off cough
infiltrates
Thank you
for
listening!