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Microorganisms can remain viable in the environment for years. Koch's bacillus is resistant to low temperatures. When boiled, it dies after 15 minutes. Mycobacteria are characterized by variability and high adaptability. After treatment, they are able to remain in the body for a long time in forms that lack a cell wall. Methods of infection with tuberculosis.
Mycobacteria are spread by sick people and animals - cats, dogs, and cattle suffer from tuberculosis. The main method of transmission of the pathogen is airborne. Infection is also possible through contact with sick animals, through food, and household items.
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The penetration of mycobacteria into the lungs and alveoli is facilitated by a chronic inflammatory process in the upper respiratory tract. Bacteria remain in the intercellular space for some time and multiply slowly. Tissue macrophages cannot destroy Koch's bacillus - the microorganism is not sensitive to lysosomal enzymes of cells. Mycobacteria absorbed as a result of phagocytosis continue to multiply inside macrophages. As a result, the immune cells die, and the pathogen again enters the intercellular space.
Tuberculosis rarely develops immediately after infection with Koch's bacillus. The infection remains latent for a long time. The impetus for the development of the pathological process is a decrease in immunity. Only in 10% of cases do adults get sick upon initial contact with the pathogen. This occurs when a large number of mycobacteria enter the body. Most often, tuberculosis affects the lungs, since Koch's bacillus, being a facultative anaerobe, reproduces best under conditions of maximum tissue oxygen supply.
Cavernous pulmonary tuberculosis occurs in the late stages of focal, infiltrative, disseminated tuberculosis, due to the disintegration of tuberculosis. A lung cavity is a cavity formed due to purulent inflammation. It is filled with necrotic caseous masses, which, under the influence of cells of the immune system and proteolytic enzymes, are liquefied and excreted through the draining bronchus along with mycobacteria. A cavity remains filled with air or exudate.
In the tissues surrounding the cavity there are pronounced focal changes in the initial stages ofno illness is noted. Tuberculosis cavities are located in the upper parts of prednisone, most often the right. In chronic cavernous tuberculosis, connective tissue capsules form around the cavities. The pathological process spreads to the lower parts of the lung and bronchi, and then to the second lung.
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The course of the disease is undulating. The first signs of exacerbation of the pathological process appear after 3-4 months of illness with other forms of tuberculosis with ineffective treatment or its absence. Symptoms worsen during the period of decay of caseous masses. The patient suffers from fever, cough with sputum or blood, and fever. When inhaling, moist rales appear. After the formation of a cavity, the patient experiences signs of general intoxication caused by bacterial toxins entering the blood.
For some time, tuberculosis can occur latently, without any symptoms. Sudden pulmonary hemorrhages may indicate a pathological process.
Cavernous pulmonary tuberculosis is diagnosed in several stages. First, the doctor collects anamnesis and assesses the general condition of the patient. Most often, a person with the cavernous form of tuberculosis is already observed in the dispensary at the place of residence. The doctor studies the medical history, previous treatment, listens to complaints and examines the patient. Auscultation does not make it possible to determine the severity of the pathological process, so fluorography is additionally performed.
If cavernous tuberculosis was detected for the first time during a preventive examination, then to confirm the diagnosis, a sputum test is performed for the presence of Koch's bacillus, bronchoscopy - examination of the lungs from the inside using special equipment, and a general blood test. An x-ray of the patient's lungs shows round-shaped cavities localized in the subclavian region.
In addition to sputum analysis, the presence of prednisone pills can be detected by examining washings from the alveoli and the cellular composition of tissues taken during a biopsy. PCR is used to determine the presence of mycobacterial DNA in the blood.
A general blood test shows a slight increase in the number of neutrophils with a decrease in the number of lymphocytes, and an increase in ESR. Cavernous pulmonary tuberculosis requires differentiation from cancer, lung abscess, bullous emphysema, pneumothorax, encysted pleurisy, and echinococcosis.