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1、2ndRespiratoryDepartmentliuyaxin13836124743aliu0707@126.comCaseAfiftyyearsoldmanpresentedtoahospital:1)Chiefcomplaint:hemoptysis,aproductivecough,nightsweatsandweightlossoverthepreviousonemonth.2)Hehadbeenseeninacommunityhealthcenterforpersistentproductivecoughandunexplainedweightloss10daysbefore,
2、butwastreatedwithantibioticsforapresumedupperrespiratoryinfection.3)Pastmedicalhistory:diabetes.4)Physicalexamination:thin,atemperatureof38.9℃;heartrate116/min,respiratoryrate32/min,therewasinspiratorycracklesandexpiratoryrhonchiintherightupperandmiddlelobes.5)Hischestx-rayrevealedarightupperlobec
3、avitaryinfiltrateandasputumsmearwaspositiveforacidfastbacilli.Whatisthepossiblediagnosisofthepatient?Ifyouarehisdoctor,whatwillyoudonext?PulmonaryTuberculosisAgeneraloutlineIntroductionEtiologyagentandEpidemiologyPathogenesisandImmunityClinicalpatternsoftuberculosisClinicalManifestationsDiagnosisD
4、ifferentialDiagnosisTreatment※※※Tuberculosisisachronicinfection,potentiallyoflifelongduration,causedbybacteriabelongingtotheMycobacteriatuberculosiscomplex.M.tuberculosisiscommom,and,rarely,M.bovis.ItwasisolatedbyRobertKochin1882.IntroductionThelungsareprimarilyinvolved,buttheinfectioncanspreadtoo
5、therorgans.Itischaracterizedbythedevelopmentofgranulartumors(nodes)intheinfectedtissues.Ifproperlytreated,tuberclosiscausedbydrug-susceptiblestrainsiscurableinvirtuallyallcases.Ifuntreated,thediseasemaybefatalwithin5yearsinmorethanhalfofcases.IntroductionEtiologyagentThetuberclebacillus(M.Tubercul
6、osis)isarod-shaped,aerobic,non-motile,non-spore-forming,highinlipidcontent,andacidandalcohol-fast(AFB).Itgrowsslowly.Itcan'ttolerateheat,butItcanliveinhumidordryorcoldsurroundings.AFB-Ziehl-NeelsonstainAcid-faststainingtechniquesA,Ziehl-NeelsonstainingofMycobacteriumtuberculosisfromsputum.Theredro
7、dsareM.tuberculosis.B,Afluorescentacid-faststainofM.tuberculosisfromsputum.AccordingtotheWorldHealthOrganization(WHO)2008report,athirdoftheworld’spopulationisinfectedbyTB.In2006,WHOestimatedthat9.2millionnewcases
