some clinical features of Tb and other forms Flashcards
what are the general symptoms of pulmonary TB?
malaise, weight loss, night sweats
what are the pulmonary symptoms of pulmonary TB?
productive cough and occasionally haemoptysis, pleurisy, pleural effusion or superimposed pulmonary infection.
what may form in the TB cavities?
an aspergilloma/mycetoma
what happens if there is laryngeal involvement ?
hoarse voice and severe cough are found
if the pleura are involved what happens?
pleuritic pain is a CPC
what is the next commonest site for infection of TB ?
lymph node TB
which nodes are more commonly involved?
Extra-thoracic nodes are more commonly involved than intrathoracic or mediastinal.
wwhat is the usual presentation of lymph node TB?
usually the infection presents as a firm non-tender enlargement of a cervical or supraclavicular node
what happens pathologically to the node ?
becomes necrotic centrally and can liquefy and be fluctulant and peripheral
what investigations should be done for Lnode tb?
culture and smear
- fine needle aspiration or CT guided biopsy
- mediastinal nodal sampling using ultrasound
CT:
what would you find on a CT of lymph node TB?
the central area of nodes appears necrotic
what happens in milliary TB?
this is where the bacilli have spread through the bloodstream to multiple sites, including the CNS in 20% of cases
haematogenous dissemination
what are the symptoms of miliary TB?
systemic upset is the rule, with respiratory symptoms in the majority
cholectasis and GI symptoms sometimes
what investigations should be done for miliary Tb?
blood cultures
BAL (usually smear negative but culture positive)
Lumber puncture should be performed in all cases unless contraindicated
CXR
why is a LB done for milliary TB?
to assess for CNS involvement
