tuberculosis

TUBERCULOSIS

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TUBERCULOSIS

The recurrence of tuberculosis is partly a consequence of the AIDS epidemic, also by multiple drug-resistant mycobacteria and partly due to the reduced effectiveness of the BCG (bacillus Calmette-Guérin) vaccination.
What is the relationship between HIV & TB?
According to the WHO: HIV is divided into ________ stages.
What are they????
And what is the purpose of this staging?????

TUBERCULOSOS

Oral tuberculosis is rare(explain) and a complication of active pulmonary disease in which the mucosa is infected from the sputum.
Have you heard of this disease?
“the new HIV/AIDS of the Americas”,






The figure shows, a tuberculous ulcer of the tongue. The rather angular shape and overhanging edges of the ulcer are typical. The patient was a man of 56 with advanced but unrecognized pulmonary tuberculosis (do we have other types of tuberculosis?)
Clinically The typical lesion is an ulcer on the middorsum of the tongue; the lip or other parts of the mouth are infrequently affected. The ulcer is typically angular or stellate, with overhanging edges and a pale floor, but can be ragged and irregular
It is painless in its early stages, and regional lymph nodes are usually unaffected. A second typical presentation is a non-healing extraction socket.
The diagnosis is rarely suspected before biopsy.





A case report of a tongue ulcer presentedas the first sign of occult tuberculosis (Kim et al. ,BMC Oral Health (2019) 19:67 )
Intraoral photograph showing a round ulcer on the tip of the tongue
Intraoral photograph presenting the lesion almost relieved
after 2 months of anti-tuberculosis therapy





Histopathological findings. Hematoxylin-eosin staining. A:Oral mucosa with intense granulomatous inflammation. B:Epithelioid cells and Langhans giant cells,. C: The presence of an aggregate of small red rods of mycobacterial organisms.





Chest computed tomography showing consolidation and fibrothorax in right lung and the cavitary lesion with clustered micronodules in left lung. A A:Coronal view. B: Horizontal view

Pathology

Typical non-caseating tuberculous granulomas containing occasional Langhans type giant cells are seen in the floor of the ulcers .

pathology

Mycobacteria are sometimes identifiable in the oral lesion by using special stains but can be
demonstrated more easily in the sputum. Chest radiographs usually show advanced infection. In tropical countries and in immunosuppression, similar features arise from fungal or atypical mycobacterial infections(EXPLAIN).
Chronic obstructive pulmonary disease (COPD): is characterized by airflow obstruction and reduced maximum expiratory flow from the lungs that is not fully reversible.
Give some examples.

Management

Diagnosis is confirmed by: biopsy, chest radiography and a specimen of sputum. Mycobacterial infection is confirmed by culture or PCR. Interferon gamma release assays used in latent infection are not used to diagnose active infection.
Oral lesions clear up rapidly if vigorous multidrug chemotherapy is given for the pulmonary infection. No local treatment is needed.(WHY??)
Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for
healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.
Tuberculin Skin Test (TST)???
TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.