Radiologi Tb

Radiologi Tb. Clinical PresentationPathologyRadiographic FeaturesTreatment and PrognosisDifferential DiagnosisThe primary infection is usually asymptomatic (the majority of cases) although a small number go on to have symptomatic haematological dissemination which may result in miliary tuberculosis Only in 5% of patients usually those with impaired immunity go on to have progressive primary tuberculosis Patients with postprimary pulmonary tuberculosis are often asymptomatic or have only minor symptoms such as a chronic dry cough In symptomatic patients constitutional symptoms are prominent with fever malaise and weight loss A productive cough which is often bloodstained may also be present 1 Occasionally patients may present with massive haemoptysis due to an erosion of a bronchial artery 13 Patients with AIDS demonstrate altered patterns of infection depending on their CD4 count When CD4 count drops to below 350 cells/mm3 pulmonary manifestations appear similar to runofthemill postprimary infections (see below) When CD4 counts drop below 200 cells/mm3 then the pattern The location of infection within the lung varies with both the stage of infection and age of the patient 1 primary infection can be anywhere in the lung in children whereas there is a predilection for the upper or lower zone in adults 1 2 postprimaryinfections have a strong predilection for the upper zones 3 miliary tuberculosisis evenly distributed throughout both lungs Radiographic features depend on the type of infection and are discussed separately In primary pulmonary tuberculosis the initial focus of infection can be located anywhere within the lung and has nonspecific appearances ranging from too small to be detectable to patchy areas of consolidation or even lobar consolidation Radiographic evidence of parenchymal infection is seen in 70% of children and 90% of adults 1 Cavitation is uncommon in primary TB seen only in 1030% of cases 2 In most cases the infection becomes localised and a caseating granuloma forms (tuberculoma) which usually eventually calcifies and is then known as a Ghon lesion 12 The more striking finding especially in children is that of ipsilateral hilar and contiguous mediastinal (paratracheal) lymphadenopathy usually rightsided 3 This pattern is seen in over 90% of cases of childhood primary TB but only 1030% of adults 1 These nodes typically have lowdensity centres with rim enhancement on CT 13 O Treatment is usually only in the setting of progressive primary tuberculosis miliary tuberculosis or postprimary infection and in general primary infections are asymptomatic For a general discussion please refer to the parent article tuberculosis Administration of protracted courses of multiple antibiotics tailored to the sensitivity of the infective strain is the cornerstone of treatment Any patient with tuberculosis should be considered infective until sputum assessment is performed and patients should be placed in respiratory isolation In many countries it is a reportable disease and contact tracing will be performed Additional targeted therapies may be necessary for the setting of empyema mediastinal complications or haemoptysis It is also important to be aware of historical treatments for pulmonary tuberculosis that may still be seen incidentally radiographically nowadays such as plombage thoracoplasty or oleothorax Some patients may show a paradoxical react The imaging differential is dependent on the type and pattern of infection consider 1 differential of miliary pulmonary opacities 2 differential of alveolar pulmonary consolidation 3 differential of a pulmonary cavity.

Tuberculosis has shown a resurgence in nonendemic populations in recent years a phenomenon that has been attributed to factors such as increased migration and the human immunodeficiency virus epidemic Although the thorax is most frequently involved tuberculosis may involve any of a number of organ systems (eg the respiratory cardiac central nervous musculoskeletal gastrointestinal and Author Joshua Burrill Christopher J Williams Gillian Bain Gabriel Conder Andrew L Hine Rakesh R MisraCited by Publish Year 2007.

Chest Xray Pulmonary disease Tuberculosis

Tuberculosis is a public health problem worldwide including in the United States—particularly among immunocompromised patients and other highrisk groups Tuberculosis manifests in active and latent forms Active disease can occur as primary tuberculosis developing shortly after infection or postprimary tuberculosis developing after a long period of latent infection Primary tuberculosis Author Arun C Nachiappan Kasra Rahbar Xiao Shi Elizabeth S Guy Eduardo J Mortani Barbosa Girish S Cited by Publish Year 2017.

Pulmonary Tuberculosis: Role of Radiology in Diagnosis and

Tuberculosis (TB) is a nonbacterial multisystem infection that often affects the lungs It may be a primary tuberculous infection secondary infection or appear as chronic scarring TB may also be seen on a chest xray as lymphadenopathy.

Tuberculosis: A Radiologic Review RadioGraphics

Postprimary Tuberculosis (“Reactivation TB”) Most cases in adults occur as reactivation of a primary focus of infection acquired in childhood Limited mainly to the apical and posterior segments of the upper lobes and the superior segments of the lower lobe Caseous necrosis and the tubercle (accumulations of mononuclear macrophages.