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group_3_presentation_2_-_tuberculosis [2018/11/02 17:31] vasavans [Effects on Other Body Parts] |
group_3_presentation_2_-_tuberculosis [2018/11/02 19:42] (current) vasavans [History of Tuberculosis] |
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| - | {{:tb.jpg?300 |}} | + | <box width centre|> Figure 1. Microscopic view of Tuberculosis. {{ :tb.jpg?nolink&300 |}}</box| > |
| ====== History of Tuberculosis ====== | ====== History of Tuberculosis ====== | ||
| - | {{ :scientists.jpg?500|}} | + | <box width centre|> Figure 2. Scientists who contributed to the theory of Tuberculosis. {{ :scientists.jpg?500|}}</box|> |
| In 1948 BC, ancient text by the Babylonian monarch Hammurabi mentions a chronic lung disease that is likely TB (Herzog, 1998). Next, Famous Greek physician Hippocrates (460-370 BC), proposed the concept of pulmonary phthisis (tuberculosis) as a common disease that usually leads to death, however he believed that it was hereditary. Later, Galen (131-201) was the first person to suspect that phthisis was contagious, and warned against intimate contact with those who are sick. | In 1948 BC, ancient text by the Babylonian monarch Hammurabi mentions a chronic lung disease that is likely TB (Herzog, 1998). Next, Famous Greek physician Hippocrates (460-370 BC), proposed the concept of pulmonary phthisis (tuberculosis) as a common disease that usually leads to death, however he believed that it was hereditary. Later, Galen (131-201) was the first person to suspect that phthisis was contagious, and warned against intimate contact with those who are sick. | ||
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| The TB blood test is recommended for patients who have previously received the TB vaccine BCG or people who have a time constraint and are unable to return to the clinic for a second test for TST. | The TB blood test is recommended for patients who have previously received the TB vaccine BCG or people who have a time constraint and are unable to return to the clinic for a second test for TST. | ||
| - | <box width centre|> Figure 2. Difference between a TB skin test and TB blood test. {{:blood_test_vs_skin_test.png?nolink&300|}}</box| > | + | <box width centre|> Figure 3. Difference between a TB skin test and TB blood test. {{:blood_test_vs_skin_test.png?nolink&300|}}</box| > |
| ====== Limitations ====== | ====== Limitations ====== | ||
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| For individuals who do not follow the entire treatment plan as prescribed by their doctor, they face the possibility of not fully recovering from the bacterial infection. This can also lead to drug-resistant TB where the medications prescribed to you are no longer effective at treating the condition. | For individuals who do not follow the entire treatment plan as prescribed by their doctor, they face the possibility of not fully recovering from the bacterial infection. This can also lead to drug-resistant TB where the medications prescribed to you are no longer effective at treating the condition. | ||
| - | <box width centre|> Figure 3. Chances of contracting TB are much higher for healthcare workers. {{ :healthcare_workers_tb.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 4. Chances of contracting TB are much higher for healthcare workers. {{ :healthcare_workers_tb.png?nolink&300 |}}</box| > |
| ====== Etiology ====== | ====== Etiology ====== | ||
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| When M. tuberculosis is detected on alveolar surfaces macrophages phagocytose the bacterium and try to destroy it, in the case of active TB the virus is able to survive and proliferates in the cell and destroys it (Crevel et al., 2002). Once this happens, other immune cells such as monocytes, lymphocytes and neutrophils are called to try and ingest the virus and fail due to the survival mechanisms of the pathogen. This failed attempt to destroy the virus leads to inflammation and then causes the formation of granulomas which are a collection of macrophages that occur when an invader cannot be eliminated (Ferrari, 1999). The granulosa has a thick calcified core that prevents the virus from exiting the capsule. The important survival factors of M. tuberculosis include the inhibition of the fusion of the virus with the lysosome via tryptophan aspartate-containing coat (TACO) protein which surrounds the capsule containing M. tuberculosis. Normally, the protein is released before phagosome fusion with the lysosomes and the breakdown of the virus occurs this is the opposite with the presence of TACO on the phagosome (Ferrari, 1999). M. tuberculosis additionally thrives through inhibition of acidification, and the protection from reactive oxygen species. The virus continues to evade destruction and the granulosa then liquefies through unknown processes which enables the pathogen to continue to proliferate and mobilize to the lungs and other tissues through the lymphatic system which aids in the destruction of the lungs (Smith, 2003). At this stage symptoms such as coughing (lasting for more than 3 weeks), chest pain or pain with breathing or coughing, fever and chills are present. | When M. tuberculosis is detected on alveolar surfaces macrophages phagocytose the bacterium and try to destroy it, in the case of active TB the virus is able to survive and proliferates in the cell and destroys it (Crevel et al., 2002). Once this happens, other immune cells such as monocytes, lymphocytes and neutrophils are called to try and ingest the virus and fail due to the survival mechanisms of the pathogen. This failed attempt to destroy the virus leads to inflammation and then causes the formation of granulomas which are a collection of macrophages that occur when an invader cannot be eliminated (Ferrari, 1999). The granulosa has a thick calcified core that prevents the virus from exiting the capsule. The important survival factors of M. tuberculosis include the inhibition of the fusion of the virus with the lysosome via tryptophan aspartate-containing coat (TACO) protein which surrounds the capsule containing M. tuberculosis. Normally, the protein is released before phagosome fusion with the lysosomes and the breakdown of the virus occurs this is the opposite with the presence of TACO on the phagosome (Ferrari, 1999). M. tuberculosis additionally thrives through inhibition of acidification, and the protection from reactive oxygen species. The virus continues to evade destruction and the granulosa then liquefies through unknown processes which enables the pathogen to continue to proliferate and mobilize to the lungs and other tissues through the lymphatic system which aids in the destruction of the lungs (Smith, 2003). At this stage symptoms such as coughing (lasting for more than 3 weeks), chest pain or pain with breathing or coughing, fever and chills are present. | ||
| - | {{ :tb_mechhh.png?300 |}} | + | <box width centre|> Figure 5. Mechanism of Tuberculosis. {{ :tb_mechhh.png?300 |}}</box| > |
| ====== Effects on Other Body Parts ====== | ====== Effects on Other Body Parts ====== | ||
| Although the lungs are the major site of damage caused by tuberculosis, many other organs and tissues in the body may be affected: | Although the lungs are the major site of damage caused by tuberculosis, many other organs and tissues in the body may be affected: | ||
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| * ** Bones:** TB likely will attack the spine and the ends of the long bones. Children are especially prone to spinal tuberculosis. If not treated, the spinal segments (vertebrae) may collapse and cause paralysis in one or both legs. | * ** Bones:** TB likely will attack the spine and the ends of the long bones. Children are especially prone to spinal tuberculosis. If not treated, the spinal segments (vertebrae) may collapse and cause paralysis in one or both legs. | ||
| - | <box width centre|> Figure 5. Tuberculosis of the Spine. {{ :tb.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 6. Spinal Tuberculosis. {{ :tb.png?nolink&300 |}}</box| > |
| * **Kidneys:** Along with the bones, the kidneys are another common site of extrapulmonary TB. There may be few symptoms even though part of a kidney is destroyed. TB may spread to the bladder. In men, it may spread to the prostate gland and nearby structures. | * **Kidneys:** Along with the bones, the kidneys are another common site of extrapulmonary TB. There may be few symptoms even though part of a kidney is destroyed. TB may spread to the bladder. In men, it may spread to the prostate gland and nearby structures. | ||
| - | <box width centre|> Figure 6. Renal Tuberculosis. {{ :tb4.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 7. Renal Tuberculosis. {{ :tb4.png?nolink&300 |}}</box| > |
| * **Female reproductive organs:** The ovaries in women may be infected; TB can spread from them to the peritoneum, which is the membrane lining the abdominal cavity. | * **Female reproductive organs:** The ovaries in women may be infected; TB can spread from them to the peritoneum, which is the membrane lining the abdominal cavity. | ||
| * **Abdominal cavity:** Tuberculous peritonitis may cause pain ranging from the vague discomfort of stomach cramps to intense pain that may mimic the symptoms of appendicitis. | * **Abdominal cavity:** Tuberculous peritonitis may cause pain ranging from the vague discomfort of stomach cramps to intense pain that may mimic the symptoms of appendicitis. | ||
| - | <box width centre|> Figure 7. Abdominal Tuberculosis. {{ :tb6.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 8. Abdominal Tuberculosis. {{ :tb6.png?nolink&300 |}}</box| > |
| * **Joints:** Tubercular infection of joints causes a form of arthritis that most often affects the hips and knees. The wrist, hand, and elbow joints also may become painful and inflamed. | * **Joints:** Tubercular infection of joints causes a form of arthritis that most often affects the hips and knees. The wrist, hand, and elbow joints also may become painful and inflamed. | ||
| * **Meninges:** The meninges are tissues that cover the brain and the spinal cord. Infection of the meninges by the TB bacillus causes tuberculous meningitis, a condition that is most common in young children but is especially dangerous in the elderly. Patients develop headaches, become drowsy, and eventually comatose. Permanent brain damage is the rule unless prompt treatment is given. Some patients with tuberculous meningitis develop a tumor-like brain mass called a tuberculoma that can cause stroke-like symptoms. | * **Meninges:** The meninges are tissues that cover the brain and the spinal cord. Infection of the meninges by the TB bacillus causes tuberculous meningitis, a condition that is most common in young children but is especially dangerous in the elderly. Patients develop headaches, become drowsy, and eventually comatose. Permanent brain damage is the rule unless prompt treatment is given. Some patients with tuberculous meningitis develop a tumor-like brain mass called a tuberculoma that can cause stroke-like symptoms. | ||
| - | <box width centre|> Figure 8. Tuberculosis of the Brain. {{ :tb2.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 9. Meningeal Tuberculosis. {{ :tb2.png?nolink&300 |}}</box| > |
| * **Skin, intestines, adrenal glands, and blood vessels:** All these parts of the body can be infected by M. tuberculosis. Infection of the wall of the body's main artery (the aorta), can cause it to rupture with detrimental results. Tuberculous pericarditis occurs when the membrane surrounding the heart (the pericardium) is infected and fills up with fluid that interferes with the heart's ability to pump blood. | * **Skin, intestines, adrenal glands, and blood vessels:** All these parts of the body can be infected by M. tuberculosis. Infection of the wall of the body's main artery (the aorta), can cause it to rupture with detrimental results. Tuberculous pericarditis occurs when the membrane surrounding the heart (the pericardium) is infected and fills up with fluid that interferes with the heart's ability to pump blood. | ||
| - | <box width centre|> Figure 9. Cutaneous Tuberculosis. {{ :tb5.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 10. Cutaneous Tuberculosis. {{ :tb5.png?nolink&300 |}}</box| > |
| * **Miliary tuberculosis:** Miliary TB is a life-threatening condition that occurs when large numbers of tubercle bacilli spread throughout the body. Huge numbers of tiny tubercular lesions develop that cause marked weakness and weight loss, severe anemia, and gradual wasting of the body. | * **Miliary tuberculosis:** Miliary TB is a life-threatening condition that occurs when large numbers of tubercle bacilli spread throughout the body. Huge numbers of tiny tubercular lesions develop that cause marked weakness and weight loss, severe anemia, and gradual wasting of the body. | ||
| - | <box width centre|> Figure 10. Miliary Tuberculosis. {{ :tb3.png?nolink&300 |}}</box| > | + | <box width centre|> Figure 11. Miliary Tuberculosis. {{ :tb3.png?nolink&300 |}}</box| > |
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| The world health organization defines TB as one of the top ten causes of death worldwide. All age groups are at risk of contracting the disease notably, individuals who are HIV positive are 20 to 30 times more likely to develop the active form of TB thus speeding the progression of both diseases. Approximately one quarter of the world's population has latent TB, these individuals have a 5-15% risk of developing active TB (WHO, 2018). The majority of cases and deaths are in developing countries although cases occur in every part of the world. India and China account for 40% of the total global TB cases. This is because TB is usually unrecognized till symptoms show additionally, the route of transmission via air particles is undetected. In spite of this, the global incidence of TB is decreasing by 2% each year (WHO, 2018). | The world health organization defines TB as one of the top ten causes of death worldwide. All age groups are at risk of contracting the disease notably, individuals who are HIV positive are 20 to 30 times more likely to develop the active form of TB thus speeding the progression of both diseases. Approximately one quarter of the world's population has latent TB, these individuals have a 5-15% risk of developing active TB (WHO, 2018). The majority of cases and deaths are in developing countries although cases occur in every part of the world. India and China account for 40% of the total global TB cases. This is because TB is usually unrecognized till symptoms show additionally, the route of transmission via air particles is undetected. In spite of this, the global incidence of TB is decreasing by 2% each year (WHO, 2018). | ||
| - | {{ :2018.png?300 |}} | + | <box width centre|> Figure 12. Geographic Prevalence of Tuberculosis. {{ :2018.png?300 |}}</box| > |
| ====== Conclusion ====== | ====== Conclusion ====== | ||
