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Chapter 16 : Pulmonary Tuberculosis

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Abstract:

The lung is the most commonly affected organ in tuberculosis infection in the immunocompetent host, with estimates of lung involvement in subjects with active tuberculosis of 79 to 87% ( ). Estimates of lung involvement are similar in immunocompromised hosts, such as those with human immunodeficiency virus (HIV) infection, with studies from the 1980 to 1990s suggesting that the rates of pulmonary involvement were on the order of 70 to 92% ( ). However, these individuals are also more likely to have extrapulmonary disease as well ( ).

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Figures

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Figure 1

Primary tuberculosis in an adult. Shown is a right lower lobe infiltrate with bilateral hilar adenopathy.

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Image of Figure 2
Figure 2

Left upper lobe tuberculosis. Shown is a typical fibronodular pattern of reactivation tuberculosis with linear densities extending to the left hilum.

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Figure 3

Late changes of upper lobe tuberculosis. Posterior-anterior chest radiograph with volume loss of the right upper lobe indicated by the elevated minor fissure. Small cavities are not clearly visible, but there is endobronchial spread to the superior segment of the right lower lobe, suggesting cavitary formation. A CT scan of the same patient that clearly demonstrates extensive bilateral cavitary disease.

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Figure 4

Miliary tuberculosis. Characteristic diffuse small nodules are seen in the posterior-anterior radiograph. CT scan of the lung in the same subject demonstrates the diffuse small nodular disease.

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Image of Figure 5
Figure 5

Tuberculous empyema. Posterior-anterior and lateral chest radiographs demonstrate a left lower lobe effusion.

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Tables

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Table 1

Increased susceptibility to tuberculosis

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Table 2

Clinical symptoms of patients presenting with active tuberculosis

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
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Table 3

Criteria for activity in pulmonary tuberculosis

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
Generic image for table
Table 4

Diagnostic difficulties

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016
Generic image for table
Table 5

Predicting active pulmonary tuberculosis

Citation: Lyon S, Rossman M. 2017. Pulmonary Tuberculosis, p 285-298. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0032-2016

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