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Primary tuberculosis.



Primary intoxication is a clinical syndrome in children and adolescents caused by primary tuberculosis infection, manifested by functional disorders in the absence of other clinical and radiological manifestations of the disease against the background of a turn of tuberculin reactions.

The primary tuberculosis complex is characterized by the presence of a triad - pulmonary pneumonic focus, the so-called. affect, lymphangitis and regional lymphadenitis (Fig. 18-22).

Features of the course: uncomplicated outcome in healing, complicated (progressive), the transition to the chronic form (Fig. 2327).

Variants of progression: “local” - a progressive primary affect or lymph-iron component of the primary complex; generalization - lymphogenous, hematogenous, mixed (in the presence of tuberculous bronchoadenitis, the lung is “secondarily” involved in 5–70%).

Complications: transformation of primary affect into a cavity, a lesion such as tuberculoma, caseous pneumonia, a breakthrough into the pleura with the development of empyema. With progressive lymphadenitis associated bronchopulmonary complications bronchial fistulas, obstructive airways disease, aspirate material pathogenic developmental caseous pneumonia, hypo- and hyperventilation, atelectasis development fibroatelektaza, bronchiectasis, polycystic and tuberculous pleurisy and pericarditis (Figure 28-38.).

Development of tuberculous meningitis, as well as generalized miliary T, is associated with hematogenous progression.

Chronically current primary tuberculosis (Fig. 39-40) occurs during the healing of the primary affect and the progressing wave-like course of the tuberculous inflammation and lymphatic-iron component of the primary complex, as well as during the development of "primary pulmonary tuberculosis".

Paraspecific tissue reactions typical for chronic primary T occur on the basis of GNT or DTH, manifest diffusely-nodular proliferation of lymphocytes and macrophages, hyperplastic processes in hematopoietic tissue, fibrinoid changes in the connective tissue and arteriole walls, and dysproteinosis (Fig. 39—40). Paraspecific reactions are the anatomical equivalent of tuberculosis masks. A typical example of “masks” is joint damage (“Ponce's rheumatism”).

Reparative processes in the foci of the primary complex occur up to 4 years after infection and disease. Pulmonary affect is primarily affected, then pleural effusion and pulmonary foci of screening. The process lasts the longest in the intrathoracic lymph nodes. Morphologically, there is a resorption of perifocal inflammation, a change in the exudative tissue reaction to a productive inflammatory process with encapsulation of the center of specific inflammation during the formation of a shaft of fibrosing tuberculosis granulations. The caseous masses are compacted due to dehydration, calcified, ossified.

Healed primary affect is referred to as Gon's focus.
In place of tuberculous lymphangitis, fibrous cord is formed.

Congenital tuberculosis (Fig. 41-43) is defined as intrauterine infection with tuberculous deciduitis and placenta or miliary T of the mother, the development of a primary disease during aspiration of infected amniotic fluid or by breathing mouth to mouth by a person carrying obstetrics; primary abdominal T for oral infection during childbirth or immediately after it.

With the penetration of the Office through the placenta and umbilical vein, large foci of caseous form in the liver, spleen, combined with hematogenous generalization. When aspirating pathogenic material in the lungs of a newborn, multiple bronchoalveolar foci of rose develop with a nonspecific perifocal inflammatory reaction, necrotic foci appear in the regional lymph nodes (Fig. 41-43). In the gastrointestinal tract in the manifestations of tuberculous inflammation also dominated by necrotic changes.

Clinical specificity of T newborns has not.

BCG vaccination (BCG). In the prevention of T (protection against primary tuberculosis infection with the danger of generalization), vaccination and revaccination play an important role, the protective effect is 80%.

The BCG vaccine, received by Calmett and Guerin in 1919 as a result of multiple passages of M.Bovis, is a live vaccine. In Russia, vaccination is carried out to all newborns (in the absence of contraindications) with BCG-M vaccine. Children of preschool and school age revaccinated three times.

The vaccine is injected intracutaneously on the border of the upper and middle third of the shoulder. The vaccination reaction appears after 4-6 weeks with the appearance of an infiltrate of 5-10 mm in size, with a crust in the center or pustules. After 2-4 months, a post-vaccination scar forms.

Contraindications to vaccination: prematurity (with a body weight of less than 2000 g), intrauterine infection, purulent-septic diseases, hemolytic disease, birth injury with neurological symptoms, acute diseases.

Complications after vaccination (0.02%): development of ulcers, infiltrates, subcutaneous cold abscesses, regional lymphadenitis, keloid scars, osteomyelitis, generalization, often in the form of generalized lymphadenopathy.

The morphological manifestations of the vaccination process and its complications are basically identical to the manifestations of tuberculous inflammation: epithelio-macrophage granulomas with multinuclear giant cells and caseous foci with a granulation shaft. With uncomplicated vaccine process in the internal organs (lymph nodes, liver, spleen, lungs) of vaccinated children for several years after vaccination, it is possible to detect single epithelioid cell granulomas without necrosis.

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Primary tuberculosis.

  1. Primary tuberculosis.
    Primary tuberculosis is a disease that coincides with the period of primary infection. Peculiarities of primary tuberculosis - children's age (may occur in HIV-infected or severely weakened patients), severe sensitization and the presence of paraspecific reactions (vasculitis, arthritis, serositis); tendency to hematogenous and especially lymphogenous generalization, lymphotropic,
  2. Primary tuberculosis
    • Characterized by: 1) the development of the disease during the period of infection, i.e. at the first meeting of the body with infektom; 2) sensitization and allergies, immediate-type hypersensitivity reactions; 3) the predominance of exudative-necrotic changes; 4) tendency to hematogenous and lymphogenous generalization. • Children are predominantly ill; lately, primary tuberculosis has become
  3. Tuberculosis
    Tuberculosis is a chronic granulomatous infection caused by mycobacterium tuberculosis. The route of transmission is airborne or alimentary. There are primary, hematogenous and secondary tuberculosis. Primary tuberculosis occurs as a result of primary infection of the human body with Koch's wand, as a result of which the primary tuberculosis complex develops. Three possible
  4. TUBERCULOSIS
    Tuberculosis is an infectious disease of humans and animals caused by mycobacteria tuberculosis, characterized by a chronic relapsing course. Tuberculosis is based on specific granulomatous inflammation. In humans, the disease is most often caused by 2 strains of Mycobacterium tuberculosis: human and bovine. Infection with human type occurs through airborne droplets, bovine -
  5. SESSION 15 THEME. TUBERCULOSIS
    Motivational characteristics of the topic. Knowledge of subject materials is necessary for the study of tuberculosis in clinical departments. In the practical work of the doctor, this knowledge is necessary for the clinical and anatomical analysis of this pathology. The overall goal of the lesson. According to the knowledge of the morphological manifestations of tuberculosis, learn to identify the clinical and anatomical variants of various forms of this serious infectious disease. Specific
  6. Tuberculosis
    1. Forms progression of primary tuberculosis complex a) bronchogenic b) in hematogenous) intrakanalikulyarnaya g) perineural d) tuberculoma correct answer: b 2. Clinico-morphological form hematogenous and tuberculosis) caseous pneumonia b) limfozhelezistoe progression c) generalized tuberculosis g) acute cavernous d) fibro-cavernous The correct answer: in 3. Cord factor
  7. Secondary tuberculosis.
    This is the most common form of tuberculosis encountered in practice. Secondary pulmonary tuberculosis occurs in adults, in whom at least a small primary tuberculosis affect, and often a complete primary complex, developed and safely healed. To date, there is no consensus about the source of infection. Apparently, secondary tuberculosis occurs either due to
  8. Hematogenous tuberculosis
    • Occurs after suffering primary tuberculosis in the presence of foci of hematogenous screening or not fully healed foci in the lymph nodes against the background of pronounced immunity to mycobacteria, but increased sensitivity (sensitization to tuberculin). • Productive tissue reaction (granuloma) prevails. • A tendency to hematogenous generalization. Varieties
  9. Lupus
    Skin tuberculosis is a group of clinical and morphological manifestations and outcomes of diseases caused by mycobacteria of human tuberculosis, less often - of bovine type. Etiology. Mycobacterium tuberculosis - short straight or slightly curved acid-resistant rods about 2.5 microns in length. Mycobacterium tuberculosis gets into the skin more often secondarily (endogenously), rarely - primary
  10. Tuberculosis
    The management of the Institutions ensures the organization and conduct of a complex of anti-tuberculosis measures, including sanitary and educational work on the issues of prevention, early detection of tuberculosis and controlled treatment of patients suffering from tuberculosis. Tuberculosis hospitals are organizational and methodological centers for tuberculosis work in institutions.
  11. TUBERCULOSIS
    The incidence of tuberculosis in pregnant women depends on its prevalence in the population and region. In recent years, there has been a marked increase in the overall incidence of tuberculosis in the Russian Federation, which causes an increase in the incidence of this pathology in pregnant women. The most common form of tuberculosis is pulmonary tuberculosis. The disease is detected in approximately 0.3
  12. TUBERCULOSIS
    Tuberculosis is a chronic infectious disease in which all human organs and tissues can be affected, but more often the pathological process develops in the lungs. Etiology. The causative agent is acid-resistant Mycobacterium tuberculosis. Human and bovine mycobacterium are pathogenic for humans. Mycobacterium is an optional anaerob, but the optimal conditions for growth are
  13. Hematogenous tuberculosis
    Hematogenous T (Fig. 44-109) is post-primary, develops on the basis of foci for eliminating the period of primary infection. There are 3 forms of hematogenous T: • generalized. • with a primary lesion of the lungs. • with predominantly extrapulmonary lesions. Generalized hematogenous tuberculosis occurs in the form of acute tuberculous sepsis (typhoid bacilli Landusi), acute general miliary and
  14. Tuberculosis
    Tuberculosis is caused by tubercle bacilli, a family of mycobacteria. Infection with tuberculosis occurs, as a rule, by inhalation due to the airborne mechanism of transmission. Dangerous mycobacteria are contained in the smallest droplets of bronchial secretions, which are formed by coughing and sneezing patients. These aerosol particles are able to stay in the air for a long time, during inhalation they
  15. TUBERCULOSIS
    Tuberculosis (Latin, English - Tuberculosis) is a severe chronic disease of animals of many species and humans, characterized by the formation of specific nodules in various organs - tubercules, which are subject to caseous necrosis and calcification (see color note). Historical background, distribution, degree of danger and damage. Tuberculosis has been known since ancient times. Signs of illness in humans
  16. TUBERCULOSIS
    Tuberculosis? an infectious disease caused by mycobacterium tuberculosis and characterized by the development of cellular allergies, specific granulomas in various organs and tissues of the polymorphic clinical picture. It is characterized by damage to the lungs, lymphatic system, bones, joints, urinary organs, skin, eyes, nervous system. Untreated, the disease progresses and ends.
  17. Tuberculosis (code A15-A19)
    Definition Tuberculosis is a chronic infectious disease caused by mycobacterium tuberculosis. Statistics. From 1990 to 1998 the incidence of tuberculosis increased by 2 times (by 97.4%) and amounted to 73.9 per 100,000 population. The incidence rate of children increased from 7.5 to 14.7 per 100,000 child population. Mortality from tuberculosis is 75% without total mortality from infectious
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