the clinical and treatment of T.B

Q. 54. Write down the clinical  and treatment of T.B ?
 Clinical features of TB :-
A. Symptoms and signs which always suspicion of TB.
1. Persistent cough.
2. Haemoptysis
3. pleural pain not associated with an acute illness.
4. Spontaneous pneumothorax.
5. Lethargy.
6. Weight loss.

B. Primary pulmonary tuberculosis
1. It is usually a childhood infection with a history of a case of active pulmonary tuberculosis
2. It is symptomless in the great majority of individuals.
3. A few patients present with following features.
(i) Fever – An irregular fever in the late afternoon.
(ii) Dry cough.
(iii) Wheeze
(iv) Erythema nodosum.

C. Features of adult post- primary pulmonary TB.
1. Tiredness
2. Malaise
3. Anorexia
4. Loss of weight.
5. Fever – evening rise of temperature low grade.
6. Haemoptysis
7. Pleural effusion.

D. Features of military TB.
Nonspecific features including:-
1. High pyrexia with drenching sweats during sleep.
2. Loss of weight
3. Marketed tachycardia
4. Hepatomegaly
5. Splenomegaly.
6. Chroidal tubercles in the eye.

E. Features of extra pulmonary TB.
1. Gastro intestinal TB: Diarrhoea, malabsorption, intestinal obstruction, ascites.
2. Pericardium:- Pericardial effusion, tamponade, constrictive pericarditis.
3. Genitourinary TB :- Haematuria, increase frequency of maturation.
4. Central nervous System TB: Headache neck stiffness, vomiting
5. Skin TB: Lupus vulgaris.

 Treatment of TB :-
Treatment of TB is divided into three types.
Category
TB Patient
TB Treatment

(i) All new smear positive case
(ii) Extra pulmonary severe ill
(i) Initial phase (2 months) 2 (4FDC) daily
(ii) Continuation phase (4 month (2 FDC) 3 day/week
Category 2
(i) Relapse case.
(ii) Failure case.
(iii) Defalter case
(i) Initial phase (3 month) 4 (FDC) daily for 3 month
Inj. streptomycin 1g daily for first 2 month
(iii) continuation phase (5 month tab 3 (2FDC) 3 days/week. Ethambutol 2g daily for 5 months.
Category 3
(i) Smear negative
(ii) Extra pulmonary
Same as Category 1