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Disseminated tuberculosis (infectious) Causes and Risks:
The infection can develop after inhaling droplets sprayed into the air as from a cough or sneeze by someone infected with mycobacterium tuberculosis. The disease is characterized by the development of granulomas (granular tumors) in the infected tissues. The usual site of the disease is the lungs, but other organs may be involved. Primary infection is usually asymptomatic . In the US, 95% of individuals will have healing of their primary tuberculous lesions with no further evidence of disease. Disseminated disease develops in the minority whose immune systems do not successfully heal the primary infection. The disease may occur within weeks after the primary infection, or may lie dormant for years before causing illness. Infants and the elderly are at higher risk for rapid progression to disease.
In disseminated disease, organs and tissues affected can include the lining of the heart (pericardium), lining of the abdominal cavity (peritoneum), larynx, bronchus, cervical lymph nodes, bones and joints, organs of the male or female urinary and reproductive (genitourinary) system, eye, stomach, lining of the brain and spinal cord (meninges), and skin. The risk of contracting TB increases with the frequency of contact with people who have the disease, crowded or unsanitary living conditions and poor nutrition. Hispanics, Native Americans, and Blacks are at higher risk for developing the disease. An increased incidence of TB has been seen recently in the US. Factors that may be causing this increase is tuberculous infection in people with AIDS and HIV infection , and increasing number of homeless people. Another factor is the development of drug-resistant strains of TB. Incomplete treatment of TB infections (such as not taking medications for the prescribed length of time) can contribute to the proliferation of drug-resistant strains of bacteria. The incidence is 4 out of 10,000 people and increasing.
Prevention:
Vaccination BCG for tuberculin-negative persons exposed to persons with untreated TB is given in some situations, but its effectiveness is under dispute.
Symptoms:
In everyone In children, additional symptoms include: Additional symptoms that may be associated with this disease: Note: The symptoms will depend upon the affected body organ.
Signs and Tests:
Enlarged lymph nodes , enlarged liver , and enlarged spleen are revealed with physical exam.
Tests: This disease may also alter the results of the following tests:
Treatment:
The goal of treatment is to cure the infection with antitubercular drugs. These drugs include Ethionamide, para-aminosalicylic acid (PAS), pyrazinamide, isoniazid (INH) rifampin, ethambutol, and streptomycin. Daily oral doses are continued for 1 year. For atypical tuberculosis infections, or drug-resistant strains, other drugs may be indicated to treat the infection.
Hospitalization is indicated to prevent the spread of the disease to others until the infectious period is over, usually 2 to 4 weeks after the start of therapy. Normal activity can be continued after the infectious period.
Prognosis:
Most disseminated forms of tuberculosis respond well to treatment.
Complications:
All medications used to treat TB have some toxicity. Rifampin and isoniazid may both cause a non infectious hepatitis . Rifampin may also cause an orange or brown coloration of tears and urine.
Other complications include:
Call Your Healthcare Provider:
Call your health care provider if known or suspected exposure to tuberculosis has occurred. All forms of tuberculosis require prompt treatment.
Kidneys can be damaged by tuberculosis. Tuberculosis generally affects the lungs, but may cause infection in many other organs in the body. (Courtesy of the Centers for Disease Control.)
Tuberculosis is caused by a group of organisms Mycobacterium tuberculosis, M. bovis, M. africanum and a few other rarer subtypes. Tuberculosis usually appears as a lung (pulmonary) infection. However, it may infect other organs in the body. Recently, antibiotic-resistant strains of tuberculosis have appeared. With increasing numbers of immunocompromised individuals with AIDS, and homeless people without medical care, tuberculosis is seen more frequently today. (Courtesy of the Centers for Disease Control.)
This chest X-ray shows coal worker's lungs. There are diffuse, small, light areas on both sides (1 to 3 mm) in all parts of the lungs. Diseases that may result in an X-ray like this include: simple coal workers pneumoconiosis (CWP) - stage I, simple silicosis, miliary tuberculosis, histiocytosis X (eosinophilic granuloma), and other diffuse infiltrate pulmonary diseases.
This chest X-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm) light areas on both sides of the lungs. Diseases which may explain these X-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, simple silicosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.
This chest X-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm each), light areas throughout both lungs. In the right upper lung (seen on the left side of the picture), there is a light area (measuring approximately 2 cm by 4 cm) with poorly defined borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these X-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.
This picture shows complicated coal workers pneumoconiosis. There are diffuse, small, light areas (3 to 5 mm) in all areas on both sides of the lungs. There are large light areas which run together with poorly defined borders in the upper areas on both sides of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.
Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, and can cause tissue death. These chest X-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying size that run together (coalesce). Arrows indicate the location of cavities within these light areas. The X-ray on the left clearly shows that the opacities are located in the upper area of the lungs toward the back. The appearance is typical for chronic pulmonary tuberculosis but may also occur with chronic pulmonary histiocytosis and chronic pulmonary coccidioidomycosis. Pulmonary tuberculosis is making a comeback with new resistant strains that are difficult to treat. Pulmonary tuberculosis is the most common form of the disease, but other organs can be infected.
Sarcoid causes damage to the lung tissue that heals by scarring. The film shows a diffuse milky and granular appearance in the normally dark lung areas. This individual has marked decrease in lung function.
Erythema multiforme - close-up of the hands: These lesions are circular and may appear in concentric rings (often called target lesions). They may be associated with other medical conditions such as the herpes infection, streptococcal infection, tuberculosis (TB), or as a reaction to chemicals or medications.
Erythema multiforme lesions are circular and may appear in concentric rings (often called target lesions). Target lesions may also be associated with other medical conditions such as herpes infection, streptococcal infection, tuberculosis (TB), or as a reaction to chemicals or medications.
Erythema multiforme lesions are circular and may appear in concentric rings (often called target lesions). When erythema multiforme affects the mouth and mucous membranes, it is called erythema multiforme major or Steven's Johnson Syndrome.
Erythema nodosum usually occurs in association with specific infections, inflammatory conditions, or medications. It consists of painful, hot, red skin lumps, usually over the shins. People with erythema nodosum should be evaluated for other disease processes.
This picture shows reddish-purple, hard (indurated), painful nodules (Erythema nodosum) that occur most commonly on the shins. These lesions may anywhere on the body and may be associated with tuberculosis (TB), sarcoidosis, coccidioidomycosis, systemic lupus erythematosis (SLE), fungal infections, or in response to medications.
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