You are on page 1of 17
PULMONARY TUBERCULOSIS Presented by: (Name of Physician) (Site)

PULMONARY

TUBERCULOSIS

Presented by:

(Name of Physician) (Site)

Pulmonary Tuberculosis

Pulmonary Tuberculosis PULMONARY TUBERCULOSIS (PTB) is a disease caused by a bacteria called Mycobacterium tuberculosis that

PULMONARY TUBERCULOSIS (PTB)

is a disease caused by a bacteria called Mycobacterium tuberculosis that is mainly acquired by inhalation of infectious droplets containing viable tubercle bacilli

Reference: DOH. http://www.doh.gov.ph/node/367.html

Signs & Symptoms

The

most common symptom of

pulmonary tuberculosis is persistent cough, productive of mucus and sometimes with blood (hemoptysis).

Approximately 75% of the patients

complain of chronic

cough (2

weeks or more) and significant

weight loss.

Sweats and chills, fatigue and body

malaise,

and

fever

are

less

consistently reported (about half of the patient population).

Reference: CDC.

Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of
Signs & Symptoms  The most common symptom of pulmonary tuberculosis is persistent cough, productive of

Is Pulmonary Tuberculosis Contagious?

Is Pulmonary Tuberculosis Contagious?  Yes, when people with active pulmonary TB cough, sneeze, speak, sing

Yes, when people with active pulmonary TB cough, sneeze, speak, sing or spit, they expel infectious aerosol droplets.

A single sneeze can release up to 40,000 droplets. Each one of these droplets may transmit

the disease,

since

the

infectious dose of tuberculosis is very low and inhaling fewer than ten bacteria may cause an infection.

Is Pulmonary Tuberculosis Contagious?  Yes, when people with active pulmonary TB cough, sneeze, speak, sing
Is Pulmonary Tuberculosis Contagious?  Yes, when people with active pulmonary TB cough, sneeze, speak, sing

Reference: CDC.

Risk Factors

The

major

factors

that

determine

the

risk of
risk
of

exposure to Mycobacterium Tubercle (MTB) include:

Number of infectious cases in the community - If there is no MTB source, there will be no exposure and, therefore, there will be no PTB!

Infectivity

-

Risk of developing the

disease is

directly proportional to the exposure to infected individuals.

Early

and

adequate diagnosis and intervention

decreases the risk of exposure of people in the community.

Reference: CDC.

Risk Factors

Number

and

nature

of

interactions

between

an

infectious case and a susceptible

contact.

Climatic Conditions - Outdoors, TB Bacilli expelled from respiratory tract of an infectious person are rapidly dispersed and are quickly

rendered nonviable by sunlight.

The risk for transmission during

such encounter is very limited.

Risk Factors  Number and nature of interactions between an infectious case and a susceptible contact.
Risk Factors  Number and nature of interactions between an infectious case and a susceptible contact.
Risk Factors  Number and nature of interactions between an infectious case and a susceptible contact.

Reference: CDC.

PTB Diagnosis: Tests and Procedures

PTB Diagnosis: Tests and Procedures • Chest X-ray (CXR) cannot be used to definitively diagnose PTB.

Chest X-ray (CXR) cannot be used to definitively diagnose PTB. Patients consulting with CXR findings suggestive of PTB should undergo sputum microscopy regardless of symptoms Sputum microscopy for acid fast bacilli (or Sputum AFB) is the initial work-up of choice for PTB suspects Sputum TB culture with drug susceptibility testing (DST) is primarily recommended for patients who are at risk for drug resistance:

All cases of retreatment / treatment failure Household contacts of patients with multidrug resistant TB (MDR-TB) patients who may be infected with HIV

Reference: http://www.slideshare.net/raissa_09/tuberculosis-2 update

Test & Procedures

Test & Procedures Sputum smear examination is the preferred method for the diagnosis of PTB. No

Sputum smear examination is the preferred method for the diagnosis of PTB. No diagnosis of PTB shall be made based on the result of X-ray examinations alone. Skin tests for PTB infection (PPD skin tests) should not be used as a basis for the diagnosis of PTB in adults.

Results of Sputum Microscopy are interpreted and reported as follows:

SMEAR POSITIVE if at least two sputum specimens are AFB (+) SMEAR NEGATIVE if none of the specimens are AFB (+) DOUBTFUL When only one of the 3 sputum specimens is (+). In this case a second set sputum must be collected again. If at least one of the second three is (+), the diagnosis is now labelled SMEAR POSITIVE.

Reference: Comprehensive and Unified Policy for TB Control in the Philippines DOH 2006

Proper Sputum Collection

Proper Sputum Collection Patient must be made aware of the importance of sputum quality. Mucus from

Patient must be made aware of the importance of

sputum quality. Mucus from the nose and throat and

saliva from the mouth are not good specimens. The

following are the steps to obtain a good specimen:

Clean and thoroughly rinse

the mouth with water.

Breathe deeply 3 times.

After the third breath, cough

hard

and

try

to

bring up

sputum from deep

in

the

lungs.

Expectorate sputum into a

clean container with a well-

fitted cap.

Collect

at

least

1

teaspoonful (5-10ml).

Examine

the

specimen

to

see that it is not just saliva.

Reference: CDC. http://www.bccdc.ca/NR/rdonlyres/E6572A06-EA63-41A1-9BA5-

Prevention

Prevention To prevent the spread of TB to other family members and the community:  The

To prevent the spread of TB to other family members and the community:

Prevention To prevent the spread of TB to other family members and the community:  The
Prevention To prevent the spread of TB to other family members and the community:  The
Prevention To prevent the spread of TB to other family members and the community:  The
Prevention To prevent the spread of TB to other family members and the community:  The
Prevention To prevent the spread of TB to other family members and the community:  The
Prevention To prevent the spread of TB to other family members and the community:  The

The

infected

person

must

cover his/her

mouth

and

nose

when

coughing

or

sneezing.

 

Allow

sunshine and fresh air

into

the home.

As much

as

possible

keep

 

windows

and

doors open.

 

N95

mask

is

the

proper

personal

protective

device

that can be used.

Reference: MAYO CLINIC. http://www.mayoclinic.org/diseases-

Treatment

Treatment  Treatment bacteria. for TB uses antibiotics to kill the  TB requires much longer

Treatment bacteria.

for

TB

uses

antibiotics to

kill the

TB requires much longer periods of treatment (around 6 to 24 months) to entirely eliminate

Treatment  Treatment bacteria. for TB uses antibiotics to kill the  TB requires much longer
Treatment  Treatment bacteria. for TB uses antibiotics to kill the  TB requires much longer

the mycobacteria from the body.

PTB drugs:

R – ifampicin I – soniazid P – yrazinamide E – thambutol S – treptomycin

Treatment  Treatment bacteria. for TB uses antibiotics to kill the  TB requires much longer
Treatment  Treatment bacteria. for TB uses antibiotics to kill the  TB requires much longer

Reference: CDC. http://www.cdc.gov/tb/topic/treatment/d

Return to Work

Return to Work Decisions about infectiousness of a person on treatment of TB should always be

Decisions about infectiousness of a person on treatment

of TB should always be individualized on the basis of the

following:

The extent of illness.

The presence of cavitary pulmonary disease.

The degree of positivity of sputum AFB smear results.

The frequency and strength of cough.

The likelihood of infection with multi-drug resistant

organisms.

The nature and circumstances of the contact between

the infected person and exposed contacts.

Reference: CDC.

Myths & False Perceptions

Myths & False Perceptions  Only thin people get TB  TB is acquired from using

Only thin people get TB

TB

is

acquired from using the

eating utensils of a TB-infected person, or from food.

TB is inherited.

TB is acquired from having sex.

Myths & False Perceptions  Only thin people get TB  TB is acquired from using
Myths & False Perceptions  Only thin people get TB  TB is acquired from using
Myths & False Perceptions  Only thin people get TB  TB is acquired from using
Myths & False Perceptions  Only thin people get TB  TB is acquired from using
Myths & False Perceptions  Only thin people get TB  TB is acquired from using
Myths & False Perceptions  Only thin people get TB  TB is acquired from using

Reference: WHO.

What You Can Do?

Take

charge

of

your

health and

live a
live
a

healthy life.

Always seek

the

advice of

your Medical Clinic Team.

Attend to your Annual Medical Check-up and have the results interpreted by your onsite physician.

What You Can Do?  Take charge of your health and live a healthy life. Always
 Do a regular follow-up check-up.
 Do a regular follow-up check-up.
3 1. The most common symptom of pulmonary tuberculosis is persistent cough, productive of mucus and

3

3 1. The most common symptom of pulmonary tuberculosis is persistent cough, productive of mucus and

1.

The

most

common

symptom

of

pulmonary

tuberculosis is persistent cough, productive of mucus

and sometimes with blood (hemoptysis).

 

2.

PTB

requires

much

longer

periods

of

treatment

(around 6 to 24 months) to entirely eliminate the

mycobacteria from the body.

  • 3. TB is NOT acquired from using the eating

utensils of a TB-infected person, or from food.

3 1. The most common symptom of pulmonary tuberculosis is persistent cough, productive of mucus and
QUESTIONS/CLARIFICATIONS
QUESTIONS/CLARIFICATIONS

QUESTIONS/CLARIFICATIONS

End of Presentation ActiveOne Health, Inc. 6th Floor Port Royal Building 118 Rada Street Legaspi Village,

End of Presentation

ActiveOne Health, Inc.

6th Floor Port Royal Building 118 Rada Street Legaspi Village, Makati City 1229 Philippines (02) 893-2925 activeonehealth.com