TB_Pleurisy_Presentation.pptx phithisopumonology

Pulmo

1. Tuberculous (TB) Pleurisy Saman Sohail Group 1 Semester 8

2. Introduction • TB Pleurisy is a form of extrapulmonary tuberculosis affecting the pleura. • It results from the spread of Mycobacterium tuberculosis to the pleural space. • It commonly presents as pleural effusion with chest pain and respiratory symptoms.

3. Epidemiology • TB Pleurisy is one of the most common forms of extrapulmonary TB. • More frequent in endemic areas and immunocompromised patients. • Occurs in about 5% of TB cases and can be an early manifestation of TB infection.

4. Pathophysiology • TB bacilli reach the pleura via hematogenous spread or direct extension from the lung. • Causes inflammation, leading to pleural effusion due to increased vascular permeability. • Effusion contains lymphocytes, high protein, and low glucose.

5. Clinical Features • Symptoms: Fever, night sweats, weight loss, pleuritic chest pain, cough. • Signs: Decreased breath sounds, dullness to percussion, pleural rub in early stages. • Can be unilateral or bilateral, depending on disease extent.

6. Diagnosis • Chest X-ray: Shows pleural effusion, possible lung involvement. • Pleural fluid analysis: Exudative effusion, high protein, low glucose, lymphocytosis. • PCR, AFB stain, and culture for Mycobacterium tuberculosis. • Pleural biopsy: Caseating granulomas confirm TB etiology.

7. Treatment & Management • Standard anti-TB therapy: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol for 2 months. • Continuation phase: Rifampicin, Isoniazid for 4-7 months. • Thoracentesis for symptomatic relief in large effusions. • Corticosteroids in severe cases to reduce inflammation.

8. Complications & Prognosis • Complications : Fibrotic pleural thickening, trapped lung, empyema. • Prognosis : Generally good with early treatment, but delayed therapy can cause permanent damage. • Prevention : Early TB detection and treatment, BCG vaccination.