Pathophysiology of Koch’s Disease arrest of a phagosome which results to bacilli

(Tuberculosis) replication
Predisposing Factors:
Necrotic Degeneration occurs
Precipitating Factors:
• (production of cavities filled with cheese-like
Age
mass of tubercle bacilli, dead WBCs, necrotic
- Occupation (e.g Health Workers)
• lung tissue)
Immunosuppression
drainage of necrotic materials into the
- Repeated close contact w/ infected
persons tracheobronchial tree
o
(eruption of coughing, formation of lesions)
Prolonged corticosteroid therapy
PRIMARY INFECTION
- Indefinite substance abuse via IV
•
Systemic Infection:
- recurrence of infection
o
Diabetes Mellitus
o
End-stage Renal Disease
o
HIV or AIDS infection

Exposure or inhalation of infected

Aerosol through droplet nuclei

(exposure to infected clients by coughing,

sneezing, talking)
Tubercle bacilli invasion in the apices of the
Lungs or near the pleurae of the lower lobes
Bronchopneumonia develops in the lung tissue
(Phagocytosed tubercle bacilli are ingested by
macrophages)

bacterial cell wall binds with macrophages
 Tuberculosis Symptoms o coughing up blood.

You may not notice any symptoms of illness until

the disease is quite advanced. Even then
the symptoms -- loss of weight, loss of energy, o Other symptoms include the
poor appetite, fever, a productive cough, and following:
night sweats -- might easily be blamed on
another disease.

o These people have a  fever,

nonproductive cough, chest pain, and
fever. The disease may go away and then
come back at a later date.
 loss of appetite,

 In a minority of people with weakened

immune systems, TB bacteria may spread  weight loss, and
through their blood to various parts of the
body.

 night sweats.
 The most common sites include the
o This is called miliary following:
tuberculosis and produces fever,
weakness, loss of appetite, and weight
loss.
o lymph nodes,

o Cough and difficulty breathing

are less common. o genitourinary tract,

 Generally, return of dormant o bone and joint sites,

tuberculosis infection occurs in the upper
lungs. Symptoms include

o meninges, and

o common cough with a

progressive increase in production of
mucus and o the lining covering the outside
of the gastrointestinal tract.
All first-line anti-tuberculous drug names have a Other drugs that may be useful, but are not on
standard three-letter and a single-letter the WHO list of SLDs:
abbreviation:
 rifabutin
 Ethambutol is EMB or E,  macrolides: e.g., clarithromycin (CLR);
 isoniazid is INH or H,  linezolid (LZD);
 pyrazinamide is PZA or Z,  thioacetazone (T);
 rifampicin is RMP or R,  thioridazine;
 streptomycin is STM or S.  arginine;
 vitamin D;
 R207910.
There are six classes of second-line drugs
(SLDs) used for the treatment of TB. A drug may
be classed as second-line instead of first-line for
one of two possible reasons: it may be less
effective than the first-line drugs (e.g., p-
aminosalicylic acid); or, it may have toxic side-
effects (e.g., cycloserine); or it may be
unavailable in many developing countries (e.g.,
fluoroquinolones):

 aminoglycosides:
e.g., amikacin (AMK), kanamycin (KM);
 polypeptides:
e.g., capreomycin, viomycin, enviomycin;
 fluoroquinolones:
e.g., ciprofloxacin (CIP), levofloxacin, moxifl
oxacin (MXF);
 thioamides:
e.g. ethionamide, prothionamide
 cycloserine (the only antibiotic in its
class);
 p-aminosalicylic acid (PAS or P).

Third line