TUBERCULOSIS

Sri Chusniati

TUBERCULOSIS
G
F O

: Mycobacterium
: Mycobacteriaceae : Actinomycetales

Morphology & characteristics:

Slender, straight or slightly curved rod with rounded ends Width from 0.2 0.5 um, length 1.5 4 um Acid-fast Non spore & non capsulated Non motile Obligate aerobe Intra cellular Gram +

Growth Properties in media

Media: Not grow in general medium Grow In rich medium + albumin (Lowenstein Jensen) Period incubation 4-6 weeks at temperature of 37o C Colonies: Dried, rough, convex color: white to yellow (M. tuberculosis) wet, flat, smooth white in color (M. bovis) In broth medium: grow spreading on the wall of the tube from the bottom to the top & form membrane in surface

Media for the growth of Mycobacterium:

- Lowenstein Jensen (glycerol) - Stonebrink (M. bovis) - Egg yolk Citrate - Potato Agar - Petragnani - Dubos Broth colonies appear after 4 6 weeks

Characteristics in biochemistry tests

Mycobacterium bovis

not form niacin & non

reduce nitrate This properties are contrariwise with Mycobacterium tuberculosis

Resistances
Sun rise directly in + 8 ours Pasteurize Suspension of cresol/phenol 5 %: 24 ours Jodium tincture: 5 minutes Resistant to 4% NaOH Resistant In rotten carcass & wet soil for 1-4 years In dried feces of cattle bacteria are able to life in 150 days

Sensitive host
cattle, poultry and human
M. bovis M. avium M. tuberculosis

M. tbc tipe bovis M. tbc tipe avium M. tbc tipe human

contagious chronic zoonoses The type of disease are acute & progressive to all organs

TUBERCULOSIS (BOVINE)
Bovine tuberculosis
The causative agent is Mycobacterium bovis It occurs worldwide, but M. bovis has been

almost eradicated from the cattle of several developed countries.

Reservoir & mode of transmission

Cattle are the natural reservoir of infection Transmission to humans is via consumption of

row milk The organism poses a serious hazard to laboratory workers

Incubation period
Humans four weeks to several years Animal variable

Antigenic Structure
Consisted of Polysaccharide, protein & lipid

Clinical features Cattle chronic disease

- Weight loss

- Bronchopneumonia extensive destruction of lung tissue progressive respiratory distress death. - Swelling of the retropharyngeal lymph node - Mastitis progressive indurations

Humans
The primary lesion enlarged cervical limph nodes - Over many months, with fever, weight loss, abdominal pain & tenderness, bone & joint lesions, meningitis with neurological sign.
-

Pathogenesis

via inhalation lung cough be swallowed gut intestine hematogen/lymphogen >< phagocyte cells multiply damage phagocyte cells form mass like cheese The injured cell stimulate the body to form epitheloid cells (to localize bacteria so the bacteria are able to spread continuously) giant cell At tubercle calcium are piled or heaped to be a thing like lime

In resistance animals

Tubercle not develop just appear in the local area named local tuberculosis (tbc lokal)

In sensitive animals
Tubercle become enlargement. In bronchus tubercle become erupts during animal coughing bacteria enter GIT and continuously spread to entire body through lymphogen/ hematogen until reach wall of intestine, liver, spleen, lung, udder, uterus general tuberculosis (tbc umum/milier) When bacteria of M. tbc are found in milk, urine and sputum, the disease named tbc terbuka

Fowl
Avian tbc occur depend on environmental sanitation Infection occur through oral and inhalation The process of tubercle formed in fowl similar with the process in cattle Predilection organs : intestine, liver, spleen, bone marrow. The disease unusual attack lung

Diagnosis:
Tuberculin Test Clinical features Pathology changes Lab examination

Tuberculin test
Generally intra dermal Methods: Shear the feather, measure the thickness of cowhide with cutimeter injection tuberculin Observation after 72 hours. Result: Fever, Increasing of cowhide thickness > 60% + < 60% -

Pathology:
Tubercle with variated size, one/joined

If cut feels like cutting sand center of

cheese-like form Tubercle esp. in lung, hepar, spleen, ren, retropharyngeal lymph nodes, bronchiale lymph nodes, mesenteric lymph nodes Giant cell, epitheloid cell

Lab examination
Sample (sputum, urine, cerebrospinal fluid, pus) If organ + papain + NaOH 2-4% wait for 30 centrifuge sediment + HCl 2N culture & incubation 37oC in 5-8 weeks if 12 weeks not growing negative Followed by microscopic BTA animal-tested

Biologic Test :
Colony centrifuged sediment + PZ

injected to 2 animal (sc/ip) Animal weak & bulge on injection area After approximately 4 weeks 1 animal killed PA/ negative After 8 weeks 1 animal killed PA/ PA/ tubercle in organs

Result of biologic test:

Fowl
M. bovis M. avium M. tbc + -

Guinea pig
+ +

Rabbit
+ + -

Differential Diagnosis
Cattle:
Pleuro Pneumonia Contagiosa Bovis

c/ Mycoplasma bovis Aspirasi Pneumonia Corynebacterium pyogenes Malleus c/ Pseudomonas mallei Johnes disease c/ M. paratbc

Fowl:
Neoplasma Aspergllosis, Mucormycosis

Penyakit pernafasan causa lain

Penyakit pencernakan causa lain

Testing material & shipping method

Sputum, pleural fluid, raw milk, organ

fresh & cool, in transport media organ in formalin 10% histopathology

Prevention & Controlling:

Animals: No Vaccination Sanitation disinfectant liquid cresol/phenol Isolation suspect animals New animal from tbc-free places Serious condition slaughtered Good condition may be cut & look after part with tubercle must be thrown away

Fowl
Good management
Sanitation New animals

from tbc-free area Reactors tuberculin + slaughtered Prevent domestic birds transmission

Treatment
Usually failed because : Cell wall of bacteria is thick Bacteria can live by intracellular Drugs penetration is slow Animals: Not attempted Humans: antituberculous chemotherapy

Health aspect:
Cattle Local tbc : consume only the sterilized milk throw infected organ away general tbc /milliar: slaughter & throw away