Tuberculosis Study Guide - M.M. Savula 2002

Secondary forms of pulmonary tuberculosis
Tuberculosis of the bronchi, trachea, and upper respiratory tract

Pathogenesis. Tuberculosis of the Larynx, Trachea, and Bronchi develops as a complication of Pulmonary Tuberculosis or intrathoracic Lymph node tuberculosis. Respiratory tract infection occurs As a result of the spread of infection via the bloodstream, lymph, or sputum. In this case, the bronchus draining the cavity is primarily infected. Direct spread of the inflammatory process to the bronchial wall from an affected intrathoracic lymph node can occur, leading to The formation of a lymphobronchial fistula. Morphologically, infiltrative, ulcerative, and fistulous forms of tracheobronchial tuberculosis are distinguished.

Clinical Features. The clinical manifestations of laryngeal tuberculosis are hoarseness and pain upon swallowing. The Diagnosis is established by laryngoscopy.

In patients with tuberculosis of the large bronchi, Complaints include paroxysmal, intractable cough that is unresponsive to antitussive drugs. Sometimes they experience retrosternal pain and dyspnea that is difficult to explain by pulmonary changes alone. The amount of sputum varies throughout the day. Hemoptysis may occur in the presence of ulcerative bronchial lesions.

Physical examination of patients with tuberculosis of the large bronchi sometimes reveals persistent wheezing In the second and third intercostal spaces.

Bronchoscopy is required to establish the diagnosis. Chest X-ray usually reveals signs of pulmonary tuberculosis, and Laboratory tests detect MBT in the sputum.

Treatment is carried out with antituberculosis drugs in accordance with the regimen for the primary form of pulmonary tuberculosis. It is supplemented by inhaled tuberculostatics and corticosteroids.