【医学课件】 Miliary tuberculosis. Tuberculous meningitis.pptVIP

* * Miliary tuberculosis.Tuberculous meningitis. Lecture № 5 The Department of Tuberculosis of KSMA Doc. Fydorova S.V. Miliary TB is consequence of hematogenous dissemination, which usually occurs during the early phase of tuberculous infection. Miliary TB is more frequent in infants, but may develop in any age. Milium (lat.) – ?millet?, because tuberculous nodi look like millet-grains. Pathogenesis and pathomorphology of miliary TB Source of hematogenous spreading of TB-infection is usually tuberculous lymph node. Caseous necrosis can rupture into blood stream, so MBT spread and enter into different organs and tissues. MBT cause allergycal changes of blood capillaries’ wall. It loss it’s smoothness, becomes rough and penetrative, so MBT sit down on the capillaries’ wall, and than they enter into interstitial space through the vessel’s wall. Pathogenesis and pathomorphology of miliary TB MBT cause allergic changes of blood capillaries’ wall. It loss it’s smoothness, becomes rough and penetrative, so MBT sit down on the capillaries’ wall, and than they enter into interstitial space through the vessel’s wall. Tuberculous granulomas form in the capillaries’ wall and in the interstitial tissue. Pathogenesis and pathomorphology of miliary TB They look like millet-grains. They have mainly productive reaction, so their borders are clear, they don’t fuse together and cavitations don’t form. Miliary foci are located in subpleural areas, where is the highest number of blood capillaries. The main clinical forms of miliary TB acute tuberculous sepsis pulmonary form typhoidal form meningitic form or tuberculous meningitis Clinical picture of acute tuberculous sepsis It is the most severe generalized form of miliary TB. It usually develops in infants or immunosuppressive patients (especially HIV/AIDS). The disease usually begins suddenly with strong dry cough, chest pain, high fever (to 40oC and more), cyanosis, severe symptoms of general intoxication. Breathlessne