PRIMARY TUBERCULOSIS

Discussion in 'DNB CET board - DipNB' started by samuel, Oct 29, 2014.

  1. samuel

    samuel New Member

    PRIMARY TUBERCULOSIS
    Most commonly seen in children
    a/w unsensitised and unexposed individuals
    source of organism--- exogenous
    most commonly starts as “LATENT DISEASE”
    unilateral hilar lymph enlargement
    GHON’S FOCUS:-
    Subpleural fibrocaseous lesion (CONSOLIDATION) of lung parenchyma (mc---lower part of upper lobe.) microscopically contains epitheloid granulomatous inflammation
    GHON’S COMPLEX:-
    Consists of Subpleural ghon’s focus and involved lymph nodes.
    Ghon's complex found below clavicle.
    RANKE’S COMPLEX :-
    ghon’s focus alongwith FIBROSIS and CALCIFICATION known as RANKE’S COMPLEX.
    SIMON FOCUS
    is a tuberculous (TB) nodule formed in lung apex.
    Due to spread of primary TB infection from elsewhere in the body to lung apex via bloodstream.
    Simon focus nodules are often calcified.

    Fibrosis
    Calcification
    Pleural effusion
    Erythema nodosum
    Phlyctenular conjunctivitis
    April 2 at 10:25am · Like · 4
    Devesh Mishra b) POST-PRIMARY (=SECONDARY)PULMONARY TUBERCULOSIS

    Seen in previously sensitized host due to reactivation of latent primary lesions
    frequently a/w decreased immune status
    PUHL’S LESION:-
    Lesion in lung apex (upper lobe )(most commonly ---- rt lung>lt lung)
    No lymph node involvement

    ASSMAN FOCUS:-
    infraclavicular lesion of chronic pulmonary T.B.
    Lymph node involvement is RARE.
    secondary TB more likely to cavitate than primary TB.
    Endobronchial spread along nearby airways is relatively common finding, resulting in relatively well-defined 2-4 mm nodules or branching lesions TREE-IN-BUD APPEARANCE on CT
    tuberculoma formation and miliary TB are also recognised patterns of secondary TB

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