VI.

PATHOPHYSIOLOGY

Age
Immunosuppression
(Prolonged corticosteroid
therapy)
Systemic Diseases
Diabetes Mellitus
End stage renal
disease
HIV or AIDS

Signs and Symptoms of

TUBERCULOSIS

Tubercle bacilli invasion in

the apices of the lungs or
near the pleurae of the
lower lobes of the lungs.

Pulmonary Symptoms

PRECIPITATING FACTORS

Acquired immunity leads to

further growth of bacilli and
development of ACTIVE
INFECTION.

Exposure or inhalation of
infected
Aerosol through droplet
nuclei by means of
coughing,

PREDISPOSING FACTORS

Occupation (ex. Health

Workers)
Repeated close contact
with person infected with
Mycobacterium
tuberculosis
Indefinite substance abuse
through IV.
Eruption of coughing,
formation of lesions
PRIMARY
INFECTION

Bronchopneumonia
develops in the lung tissue.
(Phagocytosed tubercle
bacilli are ingested by
macrophages)

Necrotic Degeneration occurs

(production of cavities filled with
cheese-like
mass of tubercle bacilli, dead WBCs,
necrotic lung tissue).
Drainage of necrotic
materials into the
tracheobronchial tree.

Lesions may calcify (Ghons

Complex) and form scars
and may heal over a period
of time.
Cavitation in the
lungs occurs
Tubercle bacilli immunity
develops
(2 to 6 weeks after
infection. Maintains in the
body as long as living bacilli

Dyspnea
Non-productive or
productive cough
Hemoptysis
(blood tinge
sputum)
Chest pain that
may be pleuritic
or dull.
Chest tightness

With
medical
interventi

Early detection/
diagnosis of the
disease.
Multiantibacterial
therapy
Fixed- dose
therapy
Impaired
TB DOTS
(Direct
mucociliary
Observed

No

Recurren

General
Symptoms

Fatigue
Anorexia
Weight loss
Low grade
fever with
chills and

Without
medical
intervention
Reactivation of the
tubercle bacilli due to
repeated exposure to
infected individuals.
(SECONDARY
INFECTION)
Severe occurrence
of lesions in the
lungs

Recurrent
bacterial
respiratory tract
infections that
were
Pulmonary
infections
damaging the
bronchial walls

Productive
cough
(Purulent
Airway
obstruction
(Dyspnea)
Abnormal
breath sounds
(Rales
&crackles
upon

Dilated bronchial
tubes amounts to lung
abscess
Excessive exudates
drain freely through the
bronchus.
Hemopty
sis

Inflammatory
scarring/fibrosis of
bronchus replace the
functioning of the lung
tissue
A segment or lobe of
lung collapse

Inflammation of
the bronchial
walls
Loss of
supporting
structures of the
bronchi

Retention of secretion
and subsequent
obstruction affects
peribronchial tissues.

Respiratory
Insufficiency
Reduced vital
capacity

Permanent
distention and
distortion of
bronchial walls

Decrease
d
ventilatio

Increased ratio of
residual volume to
total lung capacity

Ventilation
perfusion
imbalance

Bold letters actual

manifestation of the patient.

- General signs and

symptoms of PTB and
bronchiectasis

Hypoxe

Cyanosis and
clubbing of the

BRONCHIECT
ASIS