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Tuberculosis: Case Detecting

This document discusses various methods for detecting tuberculosis cases, including passive and active detection. Passive detection involves obligatory clinical and radiological exams, while active detection involves screening exams like chest x-rays for adults and Mantoux tests for children. Cultural tests and PCR tests can also be used to detect the tuberculosis bacteria, though they take more time. Radiological exams are used for detection, differential diagnosis, and treatment monitoring. Routine clinical exams may reveal symptoms like cough and chest pain. Blood tests can show abnormalities associated with tuberculosis infection.

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Rahul Patil
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31 views

Tuberculosis: Case Detecting

This document discusses various methods for detecting tuberculosis cases, including passive and active detection. Passive detection involves obligatory clinical and radiological exams, while active detection involves screening exams like chest x-rays for adults and Mantoux tests for children. Cultural tests and PCR tests can also be used to detect the tuberculosis bacteria, though they take more time. Radiological exams are used for detection, differential diagnosis, and treatment monitoring. Routine clinical exams may reveal symptoms like cough and chest pain. Blood tests can show abnormalities associated with tuberculosis infection.

Uploaded by

Rahul Patil
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Tuberculosis:

case detecting

Lecturer: Ph.D.
M.G.Dolynska
Main ways of the new cases
revealing
 Passive
Obligate diagnostical minimum (clinical,
radiological examination, direct smear
microscopy)
 Active

Screening X-ray examination for adults


Screening Mantoux test for children
Ziehl - Nielsen staining
ZN-staining
Advantages Disadvantages
 Cheapness  Low sensitivity
 Simplicity  Lack of viability and
 Quickness drug sensitivity
evaluation
 Inability to detect
mycobacteria types
Cultural test
 Lewenstein-Yensen
 Middlebrook set
 BACTEC set
Culture
Cultural methods
Advantages Disadvantages
 High sensitivity  Taking time
 Drug resistance  Expensiveness
evaluation  Hazard to the
 Possibility of typing personnel
Mantoux skin test with 5TU (Seibert) interpretation
Induration 5 mm
 Children in close contact with known or suspected contagious cases
of tuberculosis disease
 Children suspected to have tuberculosis disease because of findings
on chest radiograph consistent with active or previously active
tuberculosis
 Clinical evidence of tuberculosis disease
 Children receiving immunosuppressive therapy or with
immunosuppressive conditions, including HIV infection
Induration 10 mm
 Children at increased risk of disseminated disease:
 Those younger than 4 years of age
 Those with other medical conditions, including Hodgkin’s disease,
lymphoma, diabetes mellitus, chronic renal failure, or malnutrition
From American Academy of Pediatrics. Tuberculosis.
In: Red book: 2003 report of the committee on infectious diseases. 25th edition. Elk Grove (IL): Pickering
LK; 2003.
Mantoux skin test with 5TU (Seibert) interpretation
(continuation)

 Children with increased exposure to tuberculosis disease:


 Those born, or whose parents were born, in high-prevalence
regions of the world
 Those frequently exposed to adults who are HIV-infected,
homeless, users of illicit drugs, residents of nursing homes,
incarcerated or institutionalized, or migrant farm workers
 Those who travel to high-prevalence regions of the world

Induration 15 mm
Children 4 years of age or older without any risk factors

From American Academy of Pediatrics. Tuberculosis.


In: Red book: 2003 report of the committee on infectious diseases. 25th edition. Elk
Grove (IL): Pickering LK; 2003
Mantoux skin test procedure
Result appreciation
Result appreciation
Hyperergic tuberculin reaction
PCR-test
1. Probe processing
(DNA purification)
2. DNA melting
3. Primers hybridization
4. Complement DNA
chains building
Radiological examination:
purposes
 Case detecting
 Differential diagnosis
 Treatment control
Radiological examination:
main approaches
 Screening (fluoroscopy, roentgenoscopy)
 Additional examination – tomography
 Movement observing - radioscopy
Routine clinical examination
Complaints:
General:
 Fatigue, malaise, weakness, sweating, fever

Local:
 Cough with mucous sputum, hemophtysis

 Chest pain

 Dyspnoe
Routine clinical examination

Anamnesis:
Diseases onset:
 Sudden

 Insidious

 Wavy
Respiratory tract examination
 Percussion: dull sound, tympanic sound
 Auscultation: weakened breathing, dry or
moisture rales
Routine clinical examination

Anamnesis:
 Social and professional history
At risk:
 Low income
 Profession: industry workers, miners, health

care workers
 Family history: TB contact
 Personal history: diseases, substances abusing
Routine blood test
Normal Tuberculosis
Hb 120-160g/l ↓
Leukocytes 4,0 - 9,0 ↑ (up to 15)
eosinophil 0,5 - 5% ↑
band neutrophil 1 - 6% ↑
segm. Neutrophil 47 - 72% ↑
lymphocyte 19 - 37% ↑↓
monocyte 3 - 11% ↑
ESR 2 - 15 mm/hour ↑(up to 30
mm/hour)

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