BIO 11.

02: HUMAN BIOLOGY, HEALTH AND DISEASE, LABORATORY

Research and Findings on TUBERCULOSIS

Group Members: BRITANICO, CREUS, FERNANDEZ, SISON, ZAMORA (B)

I. Description

Tuberculosis is a contagious disease primarily of the lungs, but can also affect other parts
of the body such as the brain and the spine. It is caused by the bacteria called Mycobacterium
tuberculosis, and it can easily be spread from one person to another through tiny droplets released
into the air from coughs and sneezes. There are two types or distinctions of tuberculosis: the Latent
TB and Active TB. Latent TB is the condition where a person gets the TB infection but the bacteria
remains inactive in his or her body thus causing no further reactions or symptoms. It is not
contagious but it has the possibility to advance into active TB, thus medication is still required. On
the other hand, signs and symptoms are already manifested when one acquires Active TB that may
have developed from Latent TB. It can also be already transmitted, and may even affect other parts
of the body when left unattended. Treatments for it must be continuous as long as advised, to
prevent the bacteria to develop mutations, survive, and be able to produce drug-resistant strains
("Tuberculosis", 2019).

However, with Active TB, commonly it stays in the lungs, which is about 90% of all the
cases (Behera, 2010), and in very rare cases, the active TB may erode into the a Rasmussen’s
aneurysm, which can cause massive bleeding. (Halezeroğlu & Okar, March 2014). Furthermore,
it can cause scarring in the upper lungs (specifically the upper lung lobes), and can also become a
chronic illness, with further studies suggesting that the upper lung lobes are more affected than the
lower lung nodes, with the current reason being unknown.

II. Clinical Manifestation

Common signs and symptoms of active tuberculosis may include coughing that lasts three
or more weeks, coughing of blood, chest pains or pains while breathing or coughing, unintentional
weight loss, fatigue, fever, nights sweats, chills, and a loss of appetite. When condition is worsened
and other parts of the body are affected, symptoms may depend on which organ is involved.

In most cases of active TB, those that are mainly Pulmonary, symptoms may included chest
pains and prolonged cough producing phlegm. Though, occasional, people may cough up blood in
small amounts, however ¼ or 25% of all patients may remain “asymptomatic” by not displaying
any symptoms at all. (Halezeroğlu & Okar, March 2014)

Primary infection of tuberculosis is usually asymptomatic, although others progress to

symptomatic hematological dissemination, later resulting to miliary tuberculosis. Data show that
only 5% of patients, usually those with low resistance, proceed to progressive primary
tuberculosis. Those with post-primary pulmonary tuberculosis, on the other hand, are often
asymptomatic or have only minor symptoms, such as a chronic dry cough. In symptomatic patients,
 BIO 11.02: HUMAN BIOLOGY, HEALTH AND DISEASE, LABORATORY
Research and Findings on TUBERCULOSIS

Group Members: BRITANICO, CREUS, FERNANDEZ, SISON, ZAMORA (B)

constitutional symptoms are prominent with fever, malaise and weight loss. A productive cough
which is often blood-stained may also be present. Occasionally, patients may present with massive
hemoptysis due to an erosion of a bronchial artery (Gaillard, n.d.)

III. Chest X-Ray Findings

Chest X-Ray findings for conditions of tuberculosis vary depending on the level or
progression of the said disease.

In primary pulmonary tuberculosis, the initial focus of infection can be located anywhere
within the lung and has non-specific appearances ranging from too small to be detectable, to patchy
areas of consolidation or even lobar consolidation. Radiographic evidence of parenchymal
infection is seen in 70% of children and 90% of adults. Cavitation is uncommon in primary TB,
seen only in 10-30% of cases. In most cases, the infection becomes localized and a caseating
granuloma forms (tuberculoma) which usually eventually calcifies and is then known as a Ghon
lesion.

Meanwhile, post-primary pulmonary tuberculosis which is also known as tuberculosis

reactivated or secondary tuberculosis that occurred years later, develops in either posterior
segments of the upper lobes or the superior segments of the lower lobes within the lungs. Its typical
appearance is that of patchy consolidation or poorly defined linear and nodular opacities.

Post-primary infections are far more likely to cavitate than primary infections and are seen
in 20-45% of cases. In the vast majority of cases, they develop in the posterior segments of the
upper lobes (85%). The development of an air-fluid level implies communication with the airway,
and thus the possibility of contagion. Endobronchial spread along nearby airways is a relatively
common finding, resulting in relatively well-defined 2-4 mm nodules or branching lesions (tree-
in-bud sign) on CT.
 BIO 11.02: HUMAN BIOLOGY, HEALTH AND DISEASE, LABORATORY
Research and Findings on TUBERCULOSIS

Group Members: BRITANICO, CREUS, FERNANDEZ, SISON, ZAMORA (B)

IV. Sample X-Ray Film

Multifocal patchy opacities in the right upper lobe Bilateral airspace consolidation and pleural
with thickening and upward shift of the minor effusions are present. Widened right
fissure. (Photo retrieved from paratracheal stripe. (Photo retrieved from
https://radiopaedia.org/articles/tuberculosis- https://radiopaedia.org/articles/tuberculosi
pulmonary-manifestations-1 ) s-pulmonary-manifestations-1 )

Person with advanced tuberculosis, infection

Arrow pointing at TB cavity in the upper right
spots marked with white arrows, formed
lung. (Photo retrieved from
cavity marked with black arrows (Photo
http://tbonline.info/media/uploads/images/tb_c
retrieved from
xr.jpg ) https://upload.wikimedia.org/wikipedia/com
mons/9/9c/Tuberculosis-x-ray-1.jpg)
 BIO 11.02: HUMAN BIOLOGY, HEALTH AND DISEASE, LABORATORY
Research and Findings on TUBERCULOSIS

Group Members: BRITANICO, CREUS, FERNANDEZ, SISON, ZAMORA (B)

Sources:

Gaillard, F. (n.d.). Tuberculosis (pulmonary manifestations): Radiology Reference Article.

Retrieved October 13, 2019, from https://radiopaedia.org/articles/tuberculosis-pulmonary-
manifestations-1.

Tuberculosis. (2019, January 30). Retrieved October 13, 2019, from

https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250.

Behera, D. (2010). Textbook of Pulmonary Medicine, 2nd Edition, pg. 457, retrieved from
https://web.archive.org/web/20150906185549/https://books.google.com/books?id=0TbJjd9eTp0
C&pg=PA457#v=onepage&q&f=false

Halezeroğlu, S. & Okur, E. (2014, March 6) “Journal of Thoracic Disease: Thoracic

surgery for haemoptysis in the context of tuberculosis: what is the best management approach?”
retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949181/