Its early accurate recognition and treatment reduce morbidity and prevent mortality. Focal pulmonary tuberculosis is probably not a primary disease but a consequence of already migrated earlier disease. Necrosis was shown to be surrounded by epithelioid cells, inflammatory exudates, and lung tissue. For a discussion of the microbiology, host defense, treatment, and detection of this organism please refer to the Mycobacterium tuberculosis page. Progressive pulmonary tuberculosis is not due to increasing numbers of viable bacilli in rabbits, mice, guinea pigs, and humans who develop paucibacillary disease, but is due to a continuous host response to mycobacterial products . Pulmonary tuberculosis Computed tomography CT of the chest, abdomen, and pelvis with contrast: Abnormal lungs with widespread acinar ground glass opacification, intralobular thickening, and nodular change in a predominantly perihilar distribution. sequelae of pulmonary tuberculosis reported in about 5% of patients with chronic cavitary tuberculosis on autopsy. SUMMARY The different manifestations of infection with Mycobacterium tuberculosis reflect the balance between the bacillus and host defense mechanisms. It occurs in at least 92 per cent of all adults. 34 Determination of activity of tuberculosis process Active are such tuberculosis change at which specific process is not finished and may progress or regress. Pulmonary TB is caused by the bacterium Mycobacterium tuberculosis (M tuberculosis). If you wish to opt out, please close your SlideShare account. �/&P����>M���7!����� ��nk��mܰM��\��ZN�CG�ZQ�2���YU��#]��S�ѷCOdr�H1���t*����, ��ݹX�>��� ��I��@ܵ�. MYCOBACTERIUM TUBERCULOSIS 2. H&E staining Fig. Infiltrative pulmonary Infiltrative pulmonary tuberculosis tuberculosis pulmonary Infiltrative pulmonary tuberculosis tuberculosis 8.3 Acid-fast bacilli. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, … The infection usually stays in the lungs. Tuberculous encephalopathy, a syndrome exclusively present in infants and children, has been described by Udani and Dastur22 in Indian children with pulmonary tuberculosis. WHO estimated 600 000 cases of rifampicin-resistant tuberculosis in 2016—of which 490 000 were multidrug resistant (MDR), with less than 50% survival after receiving recommended treatment regimens. Pulmonary tuberculosis ppt download. It may be acquired between the ages of 2 and 10 years but in more than half of all individuals (in this city) makes its appearance between the ages of 10 and 18 years. Although it essentially exists subclinically, some self-limiting findings might be noticed. But the bacteria can travel through the bloodstream to other parts of the body (extra pulmonary TB). If you do not complete your treatment, then your tuberculosis will progress to a very dangerous form of tuberculosis. Pulmonary hemorrhage (or pulmonary haemorrhage) is an acute bleeding from the lung, from the upper respiratory tract and the trachea, and the alveoli.When evident clinically, the condition is usually massive. Pulmonary tuberculosis. They have a typical iso- or hyperdense centre on CT, and are usually < 2 cm in size with ring or discoid enhancement and moderate surrounding … 8.2 Epithelioid cells and Langerhans giant cells in tubercle, H&E staining Fig. Tuberculosis (TB) remains a significant public health problem worldwide, with an estimated 8.7 million cases and 1.4 million deaths from it in 2011 [].Immigration patterns, the HIV pandemic and iatrogenic immuno-suppression have made TB a more common disease in western European nations; TB rates in the UK have increased over the past 2 years [], with a rate of 14.4 cases/100,000 population. Chest imaging showed bilateral ground glass opacities. Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. You can get TB by breathing in air droplets from a cough or sneeze of an infected person. tuberculosis. Pulmonary tuberculosis is caused by Mycobacterium tuberculosis when droplet nuclei laden with bacilli are inhaled. Infectious causes are the most common, however, neoplasms, lymphoma and interstitial pneumonia also play a significant role. The pathologic form of the pulmonary infection depends on the sensitivity of the infected host and is classified as primary or postprimary (, 1–, 4). Examples of questionnaires 1.1 Screening questionnaire 1.2 Questionnaire for participants eligible for sputum examination 1.3 Questionnaire to understand why cases are missed by the NTP 2. Traditionally, protective immunity to tuberculosis has been ascribed to T-cell-mediated immunity, with CD4+ T cells playing a crucial role. Intestinal Tuberculosis. These FAQs are about pulmonary TB. Pulmonary symptoms and renal function steadily improved after initiation of anti-NTM therapy. HIV positive individuals always demonstrate multi-focal disease, systemic symptoms, either pulmonary or other organ involvement by active tuberculosis. Four patients also had pulmonary tuberculosis. The incidence of tubercular lymphadenitis is mostly seen in the extra-pulmonary involvements. We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Each infection occurred 3 months after bilateral lung transplantation in the presence of evidence implicating donor-to-recipient transmission of the pathogen. Scribd will begin operating the SlideShare business on December 1, 2020 Tuberculosis has been a disease of tremendous importance to the human race. investigations depend on the clinical presentation. Abdominal TB is very uncommon, making up to 3.25% of extra-pulmonary TB. There were 4 patients with a palpable inguinal mass, and 1 of them developed a groin sinus tract after a pre-hospital needle biopsy. LOOKING AT FOCAL LESIONS: TUBERCULOMAS, TUBERCULOSIS ABSCESSES, LOCALIZED MENINGITIS. Treatment for Pulmonary Tuberculosis Disease (TB): Various treatment ways for pulmonary tuberculosis disease (TB) are discussed in the following: Treatment for Latent TB: In latent TB one antibiotic can use to kill the bacteria and prevent active TB. The continued survival of MTB, therefore, depends upon transmission among humans. lecture doc. mised patients with tuberculosis had pulmonary involvement only, 30% had extrapulmonary in-volvement only, and 32% had both pulmonary and extrapulmonary involvement (9). Tuberculosis results almost exclusively from inhalation of airborne particles (droplet nuclei) containing M. tuberculosis.They disperse primarily through coughing, singing, and other forced respiratory maneuvers by people who have active pulmonary or laryngeal TB and whose sputum contains a significant number of organisms (typically enough to render the smear positive). 7 Most commonly, tuberculosis presents as a posterior uveitis. Tuberculosis remains the world's leading cause of death from an infectious disease, responsible for an estimated 1 674 000 deaths annually. The differential in an HIV patient with a chest complaint is broad. The patient had a remote history of pulmonary tuberculosis, which was treated with antitubercular drugs. �� � n" �� ��? Differential Diagnosis Pulmonary Tuberculosis The lung tissues were demonstrated with observable tubercles, containing caseous necrosis. Tuberculosis has been a disease of tremendous importance to the human race. THE OXFORD COLLEGE OF The effects of pregnancy on TB See our Privacy Policy and User Agreement for details. It is a great mimicker that has unusual presentations. 8.1 Pulmonary tuberculosis. In HIV negative individuals lesions are uni-focal and there are no other signs. Focal Lung Disease Although assessment of patients with focal lung abnormalities continues to represent an important problem in pulmonary diagnosis (1, 2, 3), the past decade has seen important developments both in hardware and in software applications that have transformed our approach to both the identification and especially the characterization of lung nodules. Multidetector row CT angiography (MDCTA) is an accurate method for imaging the systemic vascular network. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University.. This preview shows page 172 - 190 out of 190 pages.. focal pulmonary tuberculosis. Mycobacterium tuberculosis (MTB) is an extremely well adapted human parasite (2). Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections. 3 !1AQa"q�2���B#$R�b34r��C%�S���cs5���&D�TdE£t6�U�e���u��F'���������������Vfv��������7GWgw�������� 5 !1AQaq"2����B#�R��3$b�r��CScs4�%���&5��D�T�dEU6te����u��F���������������Vfv��������'7GWgw������� ? A high index of suspicion is essential for reaching its diagnosis. Tuberculous meningitis is the most common presentation of intracranial tuberculosis, and usually refers to infection of the leptomeninges.Uncommonly tuberculosis can be limited to the pachymeninges (dura mater), it is called tuberculous pachymeningitis and is discussed separately.. IIND YEAR MSC NURSING Pulmonary Tuberculosisintroduction Pathology&pathogenesis PPT. Moreover, these guidelines focus on interventions specific to preventing transmission of Mycobacterium tuberculosis bridging with the core components of infection prevention and control programmes at the national and acute health care facility level. Learn more. there is acute, subacute and chronic disseminated tuberculosis of lungs. Narcotizes Bronc. 8BIM' Pulmonary tuberculosis (PTB) refers to any bacteriologically confirmed or clinically diagnosed case of TB involving the lung parenchyma or the tracheobronchial tree. Additionally, a similar clinical and radiographical picture of pulmonary tuberculosis may show non-tuberculosis mycobacterium (NTM) infection. Watch this Osmosis video on the causes, diagnosis and treatment of tuberculosis. It may be acquired between the ages of 2 and 10 years but in more than half of all individuals (in this city) makes its appearance between the ages of 10 and 18 years. Introduction. reported a single case of NTM infection associated with rapidly progressive glomerulonephritis. The pathologic form of the pulmonary infection depends on the sensitivity of the infected host and is classified as primary or postprimary (, 1–, 4). Clinical and radiological findings of abdominal tuberculosis are non-specific. Focal and infiltrative tuberculosis. �NOe��� �� ������V�?P0���wŧ��S�a]g +S�Z��/Co� Focal pulmonary tuberculosis of adults is identical with the tuberculosis of childhood. Inflammatory lung diseases, such as pulmonary tuberculosis, whole lung bronchiectasis, necrotizing pneumonia, multiple or extensive lung abscesses, fungal infections, lung gangrene, and mycobacteria other than tuberculosis are considered major causes for this lung disorder. Focal pulmonary tuberculosis of adults is identical with the tuberculosis of childhood. Herein, we report the lessons we have learned over the last 30 years stemming from our own mistakes … Tuberculosis (TB) develops when Mycobacterium tuberculosis bacteria are inhaled into the lungs. Intestinal tuberculosis, once considered common, had become a relatively rare disease but is now reemerging in association with acquired immunodeficiency syndrome and with multidrug-resistant Mycobacterium tuberculosis (see Chapter 251). Definition Tuberculosis (TB) is a potentially fatal contagious disease that can affect almost any part of the body but is mainly an infection of the lungs. Introduction. Tuberculosis refers to an infectious disease associated with the lungs, which is mostly caused by bacteria. Primary pulmonary tuberculosis is often asympto‐ matic. BANGALORE. 172 Intestinal involvement with tuberculosis may be either primary, from ingestion of the organisms, or secondary, usually from a pulmonary source. Respiratory Care Devices Market is US$ 30.5 Billion by 2025 - The respiratory care device market is growing year on year due to changing lifestyle, and environmental condition such as pollution, rising geriatric population, increasing number of smokers, growth in the number of chronic obstructive pulmonary disease patients. Recent UK data suggest that extrapulmonary TB in pregnancy is as common as pulmonary disease.1,9,10 A history of recent contact with a person with TB or the presence of any of the other risk factors (Box4) should raise a suspicion of TB. SUMMARY Tuberculosis of the central nervous system (CNS) is a highly devastating form of tuberculosis, which, even in the setting of appropriate antitubercular therapy, leads to unacceptable levels of morbidity and mortality. disseminated tuberculosis - apperars during lymphohematogenous dissemination of the infection and is characterised by bilateral symetric focal lesion, which is localised in superior and cortical parts of lungs. Primary pulmonary tuberculosis manifests as five main entities: parenchymal disease. Extrapulmonary tuberculosis (EPTB) refers to any bacteriologically confirmed or clinically diagnosed case of TB involving organs other than the lungs, e.g. 6.3 Chronic Respirator y F ailure Chronic respiratory failure may complicate pulmonary tuberculosis (Sharma, 2009). there is acute, subacute and chronic disseminated tuberculosis of lungs. Tuberculosis 1. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. It is spread by inhaling tiny droplets of saliva from the coughs or sneezes of an infected person.it is a … There are various types under each type of tuberculosis. The length is usually determined by 1.2 segment. tuberculosis. Even when there is pulmonary involvement, a limited im-mune response can give rise to normal chest ra-diographic findings (10). We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. There are two types of tuberculosis, that are pulmonary tuberculosis and extrapulmonary tuberculosis. However, it is still crucial that you take treatment for it. pulmonary tuberculosis due to availability of effective anti-tuberculosis treatment. | PowerPoint PPT presentation | free to view 8,000 die/day, 2-3 million/year. Tuberculosis (TB) is one of the most prevalent infections of human beings and contributes considerably to illness and death around the world. Chest tuberculosis: radiological review and imaging. Isoniazid is a standard treatment for latent TB and need to continue for 9 momths. Historically known by a variety of names, including: No public clipboards found for this slide. Pulmonary tuberculosis must be differentiated from other diseases that cause cough, fever, night sweats, hemoptysis and weight loss, such as: brucellosis, bronchogenic carcinoma, Hodgkin lymphoma, bacterial pneumonia, sarcoidosis, mycoplasmal pneumonia. The incidence of tuberculosis varies from 9 cases per 100 000 population per year in the US to 110–165 cases per 100 000 population in the developing countries of Asia and Africa.1-3 Tuberculous involvement of the central nervous system (CNS) is an important and serious type of extra-pulmonary involvement. ing sputum) suspected of having pulmonary tuberculosis should have at least two, and preferably three, sputum specimens obtained for micro-scopic examination. People with the germ have a 10 percent lifetime risk of getting sick with TB. � ���� JFIF H H �� 'File written by Adobe Photoshop� 4.0 �� Adobe d� �� � This is best accomplished by producing a cavity in the lung for proliferati… ��v��up��J���h��!�Q��)��KHw�B��s�R6�$�/�6M�? Moreover, the absence of pulmonary tuberculosis does not rule out the diagnosis of ocular tuberculosis. Tuberculosis continues to be a major threat to global health. 8BIM� 5 - 8BIM� ����������������������� 8BIM @ @ 8BIM n � L � The bacilli were shown as red short rods,… Tuberculosis continues to be a major threat to global health. Testing is similar to that for pulmonary TB (see Tuberculosis (TB) : Diagnosis), including chest x-ray, TST or IGRA, and microscopic analysis (with appropriate staining) and mycobacterial cultures of affected body fluids (CSF, urine, or pleural, pericardial, or joint fluid) and tissue for mycobacteria. Pulmonary tuberculosis (TB) is a contagious, infectious disease that attacks your lungs. The hallmark of childhood pulmonary tuberculosis is the relatively large size and importance of the hilar lymphadenitis compared with the less significant size of ... – A free PowerPoint PPT presentation (displayed as a Flash slide show) on PowerShow.com - id: 4a56e6-ZWRkO Pulmonary Tuberculosis is a contagious, infectious disease that attacks your lungs. pulmonary or extrapulmonary and also whether it is diagnosed late in pregnancy.In a study of Indian women26 with pulmonary disease treated for 7–9 months in pregnancy,perinatal mortality was six times higher than in controls.The incidence of prematurity,small for dates and low birthweight was doubled.
MYCOBACTERIUM TUBERCULOSIS Deepshikha Chhetri MSc. 16.4 Estimation of pulmonary TB prevalence: presentation of results 16.5 Summary and conclusions PART V – Appendices 1. A moderate-sized right pleural effusion was noted. This stage is called latent TB. Standard 3. Primary Pulmonary Tuberculosis describes the pulmonary pathology and clinical consequences which result following initial infection with M. tuberculosis . TB most commonly affects the lungs, when it is called pulmonary tuberculosis, but also can involve any other organ of the body in which case it is called extra-pulmonary tuberculosis. Privacy 14. Deepak Leichombam Focal tuberculosis focal TB - is a form of the disease which is characterized by limited extent of inflammation in the lungs with a predominance of productive nature of inflammation in the body. Accounts for 1/3 AIDS deathes. … This review provides an update on the presenting symptoms, signs, investigation and management of diseases affecting the lung caused by protozoa, nematodes and trematodes. This is reminiscent of the early infiltrate … In this case the primary tubercular foci can be cured, and there comes the secondary stage of the disease. Pulmonary tuberculosis is caused by Mycobacterium tuberculosis when droplet nuclei laden with bacilli are inhaled. Treatment for pulmonary tuberculosis Firstly, it is worth noting that latent tuberculosis has no symptoms and there is no way you can pass it to another person either. The characteristic features of this entity are the development of a diffuse cerebral disorder in the form of convulsions, stupor and coma without signs of meningeal irritation or focal neurological deficit. kravchenko n.s. Tuberculosis (TB) is an infectious disease caused by a type of bacteria called Mycobacterium tuberculosis. During a 5-year study period, we diagnosed pulmonary tuberculosis in two (2%) of 94 lung and heart-lung transplant recipients. Dr. Nikhil Oza Intern BVDUMC A presentation on- 2. Clinical manifestations and complications of pulmonary tuberculosis. The resulting lung infection is called primary TB. The diagnosis is difficult and delayed due to non- specific clinical and imaging features. �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������F�w� ��`7\��q4��Y����� JFIF H H ��Photoshop 3.0 8BIM� H H 8BIM� 8BIM PRESENTED BY; Cavitation is a dangerous consequence of pulmonary tuberculosis associated with poor outcomes, treatment relapse, higher transmission rates, and development of drug resistance. It the past 200 years tuberculosis (TB) has killed more people than all other epidemic infections combined and it still kills around 5,000 people per day, more than any other infection (1). Neo-latin word : - Round nodule/Swelling - Condition “Tubercle” “Osis” 3. >AIDS& malaria. Tuberculosis (TB) is common in India. �?D#��G����p��� @IO?�zj��6��x�.�e`Htcc�V as�$���(��v"�o�_�%7��n�)9���J����!k�l��P��p$9%>_����f��4y�3������ҩ�g�A�H��\�W�{�$2��J|��syL��U�/�z�}���#� ���F8:F�c�@G��@ԩ q��,1��;�d�[��p�{�D 1 Focal lung tuberculosis; 33 fig.2 Roentgenogram. Ppt. Pulmonary Tuberculosis Finding “Typical” (Reactivation) “Atypical” (child, HIV) Opacity 85% Upper 60% Upper 40% Lower Cavitation Common Rare Adenopathy Uncommon Children common (Unilateral > Bilateral) Effusion May be present May be present Radiographic Patterns: Pulmonary TB. PRESENTED BY; UMADEVI.K IIND YEAR MSC NURSING THE OXFORD COLLEGE OF NURSING BANGALORE 2. Other nonspecific symptoms were found, such as fever in 12 patients, sweating in 8, poor appetite in 6, and weight loss in 2. secondary. Clipping is a handy way to collect important slides you want to go back to later. Focal lung tuberculosis . NURSING The lymph nodes are swollen and tender. The focal pulmonary tuberculosis of children and. You are here: Tuberculosis (TB) TB publications; What we do. When possible, at least one early morning specimen should be obtained. Fibrous-focal tuberculosis may be the next stage of development of soft-focal tuberculosis or involution of other forms. Savvas Andronikou, Nicky Wieselthaler, in Tuberculosis, 2009. TB has affected humans for millennia. The clinical presentations and … According to statistics, every second case of TB is identified focally. Fig. {�0k��_�q�g-�;�SC3���6=�:Ah5��C��O���:�pte6s�SCZ�C�;��?u*�M���)-�O.-��IOW�붠Z�ohճ�՟l����k�>�������jS���f����+f���1�7��!ڐ'H������Ѵ9�Ku0�I�;��%"K'�-����`� \o���������i���J���am�i��ۡ� 7�m`Ս[E؏�߷�\��IOOS�� �S�W�\n��#k�s|վ�)���Z�D�ѕC%�T׃2��Y:$�+=�(li��+"�L'�D�5'������qɧB>�����k�}���y�����e��+kA� �����ҳm���@H�;���X��Ĥ�$X�H��~K�2��9�!� ƀO�RS���Y_�Ai�*�h��1������$��4�o�k��t� ��l�~��n���\�Ro�����Ѵ5%�H�.��pV0(�����qsH����������ݹ����)cf[�`��&����%=�L��k\�$C��#HY!�kL��qƽִ�S�ӹ�3X�O!tm�v1{9��o�֮��6�'X��RS[$R���x��|��˲�6F�N�k?5;����.ݴ�. If you continue browsing the site, you agree to the use of cookies on this website. The typical symptoms of pulmonary TB include fever, night sweats, abnormal fatigue, productive cough, and hemoptysis. Associated paratracheal lymphadenopathy may occur because the bacilli spread from the lungs through the lymphatic system. Parasitic infections of the lung occur worldwide among both immunocompetent and immunocompromised patients and may affect the respiratory system in a variety of ways. ˏ��2������ �i��;�IN�z�+9%��� �����ׯ�q��7�f܊�fXd7�[�6�V�h>�G�4�� ������} m����������� Therefore, in immuno- 1/3 world population is infected. 32. fig. Isolated hepatic and splenic TB in the absence of disseminated disease is exceedingly rare and poorly described in the literature [3]. Chen et al. It must be treated. To assess outcomes among close contacts of patients with active tuberculosis, Marks and coworkers identified an urban sample of 1,080 patients with smear-positive pulmonary tuberculosis and a median of four close contacts per patient.Of eligible contacts, 88% received tuberculin skin tests and 36% had positive reactions. You can change your ad preferences anytime. PULMONARY TUBERCULOSIS AISHA M SIDDIQUI PULMONARY TB FACTS HISTORY DEFINITION EPIDEMIOLOGY PATHOLOGY CLINICAL FEATURES DIAGNOSIS COMPLICATIONS PREVENTION CHEMOTHERAPY REFERNCES FACTS “If you know TB, you know medicine” Sir William Osler. Hemoptysis of pulmonary arterial origin is a diagnostic challenge in patients admitted to a respiratory ICU (RICU) for treatment of hemoptysis. Looks like you’ve clipped this slide to already. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. Diagnosing abdominal tuberculosis remains a great challenge even for experienced clinicians. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. common presentation is pulmonary TB, extra pulmonary TB accounts for around 13% of all TB cases [2]. 858 FOCAL PULMONARY TUBERCULOSIS The proportion of instances of fatal tuberculosis in Table I is of little significance since it depends upon the frequency with which tuberculosis is admitted to the two hospitals from which autopsies were obtained. kravchenko n.s. If you continue browsing the site, you agree to the use of cookies on this website. Ten patients with a history of pulmonary tuberculosis (9.4%) had less than half of their expected vital capacity vs one patient (0.53%) in the LTBI group. UMADEVI.K Enfold What's new in tb in 2018. As of this date, Scribd will manage your SlideShare account and any content you may have on SlideShare, and Scribd's General Terms of Use and Privacy Policy will apply. Pulmonary tuberculosis ppt 1. The natural history of this potentially fatal condition remains poorly understood and guidelines for optimal management are controversial. This means the bacteria is easily spread from an infected person to someone else. Presentation Summary : Module 1 – Transmission and Pathogenesis of Tuberculosis. 1. See our User Agreement and Privacy Policy. While MTB can infect many animals, they cannot transmit the infection to others. Pulmonary manifestations of HIV/AIDS are a major contributor to morbidity and mortality related to the disease. It is one of the known endemic diseases in this part of world; the organ to be mostly affected is lung. lecture doc. 8. disseminated tuberculosis - apperars during lymphohematogenous dissemination of the infection and is characterised by bilateral symetric focal lesion, which is localised in superior and cortical parts of lungs. Tuberculomas are the commonest focal TB lesions resulting in seizure (> 95%). The onset of pulmonary hemorrhage is characterized by cough productive of blood (hemoptysis) and worsening of oxygenation leading to cyanosis. Tuberculosis can have a variety of ocular manifestations, and consequently may mimic a number of ocular inflammatory diseases. Cavitation is a dangerous consequence of pulmonary tuberculosis associated with poor outcomes, treatment relapse, higher transmission rates, and development of drug resistance. ��ࡱ� > �� ���� Now customize the name of a clipboard to store your clips. TB is contagious. secondary. Tuberculosis results almost exclusively from inhalation of airborne particles (droplet nuclei) containing M. tuberculosis.They disperse primarily through coughing, singing, and other forced respiratory maneuvers by people who have active pulmonary or laryngeal TB and whose sputum contains a significant number of organisms (typically enough to render the smear positive).

focal pulmonary tuberculosis ppt

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