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Mycobacteria (TB (treatment (first line : (Rifampicin, Ethambutol,…
Mycobacteria
TB
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risk factors : HIV , DM , recent infection with TB and immunocompromised
primary TB : 1 heals by calcification 2-invade blood and cause CNS Miliary disseminated infection which spread and involve spleen liver and lymphs 3-glands compress bronchus persistent pneumonia despite antibiotics and mimic community acquired pneumonia
secondary TB : occurs in previously infected patients , reactivation of dormant infection ( haemoptysis and cavitation ) or exogenous reinfection
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diagnosis :
clinical suspicion : specific symp haemoptysis .. systemic symp weight loss fatigue pyrexia and night sweat .. no antibiotic response
TB screening : skin test mantoux intradermal injection of protein derivative of tuberculin ,, QuantIferon whole blood essay - does not distinguish between active and latent TB
Microbiology : sputum , EMU, CSF , pus, ZN stain or auramine cultured by LJ , PCR and radiology CXR,CT,MRI
Non TB
M.Avium: intracellular complex..from soil and water.. primary infection in AIDS..difficult to treat..prophylaxis in HIV
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often found in the environment , less pathogenic and not considered infectious , respiratory infection often seen in patient with underlaying disease such as CF
M.leprosy: never grown in vitro .. do not stain .. associated with disfigurements.. schwan cells are ,primary target and cause paralysis, anaesthesia , skin lesions w/out pigmentations nasal destruction and eye lesions diagnosis by tissue smear for AFB treated with rifampicin and clofazimine
types
Non TB : M.kansassi , M.leprae
TB : M.tuberculosis , M.Bovis , M.ricanum
Aerobes , non spore forming , non motile rods , cell wall with high lipid content - difficult to stain and difficult to treat - .. require special media