Pathophysiology of Multiple Drug Resistant Tuberculosis

Normal Physiology

Inhalation of Air (Oxygen)

Respiratory tubes and alveoli

Absorption of Oxygen in the blood stream, tissues and organs

Waste gas created in tissues (CO2)

Releaseof CO2 (Exhalation)

History
Had an inconmplete course of regimen for the
diagnosed Pulmonary Tuberculosis two (2) years ago
(March 17, 2014)

Predisposing Factors:

Nationality: Filipino
Age: 48 yrs old
History of Pulmonary
Tuberculosis 2 years
ago with incomplete

Precipitating Factors
Smoker ( 1 pack/day-20pcs)
Alcoholic (3 bottles/day)
Living in overcrowded areas
Poor hygiene

DOB,coughing with stinge of blood for 3 days.

Laboratory and Diagnostic Exam Results

Etiology:
Mycobacterium
tuberculosis

Etiology:
Mycobacterium
tuberculosis

Exposure or inhalation of infected droplet

nuclei from infected clients by coughing,
sneezing, talking, laughing and singing

Tubercle bacilli invasion in the apices

of the lungs or near the pleurae of
the lower lobes

Bronchopneumonia develops in the

lung tissue and tubercle bacilli are
ingested by wandering macrophages

Many of the bacilli survived before

hypersensitivity and immunity develops

Surviving bacilli is carried into

bronchopulmonary lymph nodes via
the lymphatic system and may even
spread throughout the body

Inflammatory response occurs, TB

specific lymphocyte produces T-lytic
enzyme which lyses bacteria and
alveolar tissue

Material (bacteria & macrophage)

become necrotic

Production of cavities filled with

cheese-like mass of tubercle
bacilli, dead WBCs, necrotic lung
tissue

- productive cough
- phlegm
- crackles

Drainage of necrotic materials into

the tracheobronchial tree

PRIMARY INFECTION
Lesions heal over a period
of time by forming scars
and later being calcified

Partial occlusion which

interferes w/ the diffusion
of O2 & CO2

Areas of the lungs are

inadequately ventilated

oxygen
carrying
capacity

With medical
intervention:

Tubercle bacilli immunity develops

(2 to 6 weeks after infection)
(maintains in the body as long as
living bacilli remains in the body)

- Early detection/
diagnosis of the disease
- Multi-antibacterial
therapy
- Fixed- dose therapy
- TB DOTS (Direct
Observed Therapy)

Inhibits further growth of the

bacilli and the development of
active infection (bacteria
becomes dormant)

Good prognosis

Reactivation of the tubercle

bacilli

hypoxia

- pallor
- weakness
- fatigue
- tachycardia
- chest pain
- tachypnea
-dizziness

Reinfection

SECONDARY INFECTION
immune system
Bacteria becomes
resistant and survives

Active infection develops

Ulceration of the lesions

in the lungs

Severe occurrence of lesions

in the lungs leading to abscess

hemoptysis
Accumulation of
pus in the chest
cavity
(empyema)

Lung consumption

alveolar tissue
leading to oxygen

DEATH

- chest pain
- fever and chills
- excessive sweating
- loss of appetite
- muscle wasting
- weight loss
- body malaise

dyspnea