Tuberculosis

Dr. Bikash Puri

M.V.Sc (Veterinary Pathology)
Lecturer, IAAS, Paklihawa Campus
 INTRODUCTION
• A chronic contagious bacterial disease of human & animals

• Characterized by development of tubercules in lungs,

spleen and lymph nodes

ETIOLOGY
– Mycobacterium tuberculosis (Human)

– Mycobacterium bovis (Cattle, pig, dog, cat, etc)

– M. avium (birds, pig, sheep and horse)

– It is a acid fast organism , stained by Ziehl Neelsen’s method.
 TRANSMISSION
– Inhalation of infected air droplets or fomites

– Also via infected milk and milk products

– Through contact with infected animal

discharges (sputum, feces, urine, vaginal
discharge, semen, lymph, discharges from
wound, etc.)

– Genital tract during coitous

 PATHOGENESIS
• Occurs in two stages
1. Primary complex formation
• Primary focus in cattle and human is lungs and intestinal tract
in poultry
• Lesion is found at point of entry or mesentric lymph node
• Visible primary focus develop within 8 days of entry of
organism
• 2 wks later calcification of lesion starts
• Then necrotic focus is surrounded by granulation tissue and
lymphocytes
• Ultimately formation of tubercles.
 PATHOGENESIS
2. Post primary dissemination
• Varies considerably in rate and route
• May take in the form of acute milliary tubercles in which discrete nodular lesion
are found in various organ.
Note: Pathogenicity of M. tuberculosis is due to its ability to escape killing by macrophages
and induced delayed type hypersensitivity.
1. Cord factor-
– a surface glycolipid
– Only virulent strain posses cord factor
– Causes formation of characteristic granuloma

2. Lipoarabinomannan (LAM)-
– Inhibit macrophages activation
– Induces macrophages to secrete Tumor Necrosis Factor-alpha which causes fever, weight loss and tissue
damage and Interlukein-10 that suppress mycobacterium induced T-cell proliferation.
 PATHOGENESIS
3. Complement:
– Upon activation it opsonizes the organism and facilitate its uptake by macrophages
complement receptor.

4. M. tuberculosis heat shock protein

– Has role in auto immune reaction.

Inhalation Phagocytized by macrophages

Transported by these cells to LN

Normal macrophages are unable to

digest
 SYMPTOMS
– Fluctuating temperature

– Erratic appetite

– Progressive emaciation

– Rough hair coat

– Chronic cough due to bronchopneumonia

– Intestinal ulceration and diarrhea

– Enlargement of lymph node.

 GROSS FINDINGS
– Consolidation of lungs

– Nodules of tubercle present in lungs containing

cheesy mass

– On cutting of tubercle, a gritty sensation and gritting

sound is felt

– Granulomatous lesions in spleen, lymph nodes, liver

and intestine.

– Tubercle on pleura and mesentery ---pearly disease.

 Pulmonary tuberculosis

Large multifocal to confluent caseating granulomas are

present in the pulmonary parenchyma. Note the caseous
(“cheesy,” pale yellow-white) appearance of the
granulomas, which is typical of bovine tuberculosis.
Granulomatous nodules beneath the
intestinal mucosa
 Lymph node with numerous caseous
granules

The normal architecture of the lymph node has

been completely obliterated by multiple caseating
granulomas, typical of Mycobacterium bovis lesions.
 MICROSCOPIC FINDINGS
– Tubercles consist of central area of caseation necrosis
surrounded by a layers of gaint cells and
macrophages, a layers of lymphocytes and a thin
layers of fibroblasts.

– Demonstration of acid fast staining bacilli in the

gaint cells and macrophages.
 Granulomas

Several noncaseous granulomas (arrows), each with a

small necrotic center filled with neutrophils, surrounded by
histiocytes and mononuclear cells, and with an outer rim of
connective tissue.
 Diagnosis
– Symptoms and lesions

– Demonstration of acid fast bacteria

– Tuberculin testing of animals (0.1 ml of Tuberculin

reagent is administered intra-dermally in neck. In
positive case area appears red, hot and painful with
swelling and thickening of the site (>4mm) after 72
hrs.

– Serological tests: ELISA,

 Differential Diagnosis
– Paratuberculosis

– Coligranuloma