Question

Part 4: The Casualty - Clinical Manifestations What is the outcome of the infection? Describe clinical symptoms of the disease.

Answer 1

​1. WHAT IS THE OUTCOME OF THE INFECTION ?

ANSWER:-

• Tuberculosis is cause by the bacterium Mycobacterium tuberculae. Tuberculosis is associated with many factors which in turn leads to adverse effects on health. The onset of symptoms and resolving depends upon many factors like age of the person, gender and presence of any other disease associated with the existing symptoms of tuberculosis. Tuberculosis is severe in cases of patients already suffering form HIV infections, Diabetes Mellitus and Cancer and at the same time the risks associated are more in case of drug users and healthcare workers. In case of individuals provided with drugs such as corticosteroids or immunosuppressants, the immune system becomes weak for a short duration mostly in case of conditions in which the antibodies act against the self tissues damaging them. These are some factors associated with outcomes as listed below

	Gender	Number of patients	Success rate (treatment)	Failure of treatment	Death percentage
All groups	Male	23037	54% (12439)	1.3%	23.7%
	Female	10662	59% (6290)	0.8%	18.9%
HIV patients	Male	55	38.2%	1.8%	9.1%
	Female	8	25%	12.5%	12.5%
Contact cases	Male	246	69.9%	1.2%	4.5%
	Female	117	70.9%	1.7%	6.8%

• ​​​​​​The table mentioned above deals with the data in percent as the outcomes of the diagnosis and treatment survey carried out in Japan in the years (2007-2010). In contact cases, the death rate is relatively less. Rate of success associated with treatment and survival is maximum in case of the contact cases.

2. DESCRIBE CLINICAL SYMPTOMS OF DISEASE.

ANSWER:-

1. Tuberculosis can be stated to have three stages out of which two are symptomatic including the latent phase and the active phase. Latent phase may or may not be symptomatic. Symptoms usually resolve within weeks but can get reactivated resulting in active stages of tuberculosis.
2. The symptoms are mild and includes formation of small lesions in the form of Ghon complex having a region of Ghon focus provided on sides by hilar lymphadenopathy which is a condition in which the lymph nodes achieve an abnormal size. These features arw diagnosed by means of chest X-ray. Pulmonary hilar is a branching structure from pulmonary trunk present towards the downward portion and hence chest X-ray scans during primary stages shows infected regions in the lower lobes of lungs. Lymphadenopathy is associated with swelling of the lymph glands which in turn leads to passing of the infiltrate to other regions of the lungs. This is called as Disseminated tuberculosis which in turn leads to the formation of a military like pattern in the lungs and characterized the final stages or the later stages. These are characterized by presence of infiltrate in the Upper lobes of the lungs. The bacteria spreads through blood vessels and lymph nodes to other parts of body such as spleen, liver and may lead to systemic symptoms like fever, Malaise, weight loss, fatigue, loss of appetite, night sweats along with enlargement of liver and spleen due to infection (Spleenomegaly and Hepatomegaly).
3. The lung tissue is very sensitive and delicate and is usually involved in exchange of respiratory gases. The bacteria leads to destruction of the tissue and resulting in two fates. In one case, the tissue gets solidified resulting in the process of fibrosis in which there is insufficient oxygen exchange. Apart from this, the second fate leads to cavitation along with damage of the tissue leading to formation of sputum which gets collected inside the cavities. This is the characteristic diagnostic feature of Tuberculosis. The process in which there is transfer of the infected filtrate to other parts of the lungs ultimately lead to Bronchopneumonia resulting in certain systemic and physical symptoms.