What is tuberculosis?Pulmonary tuberculosis PTB is a pulmonary infectious disease caused by Mycobacterium tuberculosis, and it is a serious threat to human health. Tuberculosis (TB) has spread through breathing routes, and statistics from the WHO (WHO) show that TB is the 800~1000 largest in the world every year. Tuberculosis is the single infectious disease that causes the largest number of deaths.
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which can invade many organs. Tuberculosis is the most common infection. The excretor is an important source of infection. Human infection with Mycobacterium tuberculosis does not necessarily lead to clinical morbidity. When resistance decreases or cell-mediated allergy increases, it may lead to clinical morbidity. If timely diagnosis and reasonable treatment can be given, most of them can be cured clinically.
There is a relatively close history of TB contact, and the onset can be acute and slow. Most of them are low fever (afternoon), night sweats, fatigue, Nash, emaciation, and female menstrual disorders. Respiratory symptoms include cough, expectoration, hemoptysis, chest pain, varying degrees of chest tightness or dyspnea.
Pulmonary signs vary according to the severity of the disease and the scope of the disease. It is not easy to find positive signs in early and small-scale tuberculosis. Those with a wide range of lesions show voiced percussion, enhanced speech fibrillation, low alveolar respiratory sound and wet rale.
Advanced tuberculosis forms fibrosis, local contraction causes pleural collapse and mediastinal displacement. In the early stage of tuberculous pleurisy, there is pleural friction sound. When a large amount of pleural effusion is formed, the chest wall is full, the percussion is turbid, the speech tremor and respiratory sound are reduced or disappeared.
Classification and staging of pulmonary tuberculosis
(1) Classification of pulmonary tuberculosis
① Primary pulmonary tuberculosis (type I) is the primary syndrome with dumbbell changes of intrapulmonary exudative lesions, lymphangitis and hilar lymph node enlargement, which is common in children, or only manifested as hilar and mediastinal lymph node enlargement.
② Hematogenous disseminated pulmonary tuberculosis (type II) includes acute miliary pulmonary tuberculosis and chronic or subacute hematogenous disseminated pulmonary tuberculosis. Acute miliary pulmonary tuberculosis: miliary shadows scattered in both lungs with the same size, equal density and uniform distribution, which can fuse with each other with the progression of the disease; Chronic or subacute hematogenous disseminated pulmonary tuberculosis: there are nodules and cord shadows with different sizes, different old and new lesions, uneven distribution, fuzzy or sharp edges between the two lungs.
③ Secondary pulmonary tuberculosis (type ⅲ) this type includes a variety of changes in which the lesions are mainly proliferation, infiltration, cheese or cavity. Infiltrating pulmonary tuberculosis: X-ray often shows cloud flocculent or small patch infiltrating shadow, fuzzy edge (exudative) or nodule, cord (proliferative) lesions, large consolidation or spherical lesions (caseous – visible cavity) or calcification; Chronic fibrous cavitary pulmonary tuberculosis: mostly in the upper part of both lungs, also unilateral, with a large number of fibrous hyperplasia, in which the cavity is formed, in the form of broken cotton wadding, the lung tissue shrinks, the hilar is raised, the hilar shadow shows “weeping willow like” changes, pleural hypertrophy, thoracic collapse, and local compensatory emphysema.
④ Tuberculous pleurisy (type IV) has pleural effusion on the diseased side, with a small amount of shallow costophrenic angle, and more than a medium amount of effusion is a dense shadow, with an arc on the upper edge.
① for the newly discovered active pulmonary tuberculosis in the advanced stage, the lesions increased during follow-up, there were cavities or cavity expansion, sputum test turned positive, fever and other clinical symptoms aggravated.
② In the follow-up period of improvement, the absorption of lesions improved, the cavity narrowed or disappeared, the sputum turned negative, and the clinical symptoms improved.
③ In the stable stage, the cavity disappeared, the focus was stable, and the sputum bacteria continued to turn negative (once a month) for more than 6 months; Or the cavity still exists, and the sputum bacteria turn negative continuously for more than 1 year.
Tuberculosis has typical symptoms of fever, cough, expectoration, blood in sputum or hemoptysis, as well as systemic symptoms such as fatigue, night sweat, anorexia and weight loss, as well as chest pain, dyspnea and other symptoms.