Study of respiratory symptoms among sputum positive
Study of respiratory symptoms among sputum positive Study of respiratory symptoms among sputum positive
.... £fwwoj"£itertltua 3) Erythema nodosum : Erythema nodosum has been reported to have accompanied primary tuberculosis infection in 1-2(1'0 of British (Daniels, 1948 and Thompson, 1952) and 5-15% of Scandinavian cases (Crofton, 1954). It is rare below the age of seven, with an increase in frequency up to puberty. It is commoner in girls than boys at all ages and after puberty 80.90% ofcases are in females (Ustvedt, 1977). The characteristic feature of erythema nodosum is the presence of tender dusky-red slightly nodular lesions on the anterior surfaces ofthe legs, although lesions are occasionally also found on the anterior surfaces of the thighs, the extensor surfaces ofthe forearms and rarely on the face and breasts. The nodules are usually 5-20 mm in diameter, have ill- defined margins and may become confluent. They usually resolve over a week or two, the red color fading to purple and then brown, the brownish pigment often persisting for several weeks. Recurrent crops oflesions may occur (Leitch, 2000). 4) Phlyctenular conjunctivitis: This condition reflects hypersensitivity to the tubercle bacillus, but unlike erythema nodosum is not necessarily confined to the first weeks of infection. It usually occurs within the first year (Price and McManus 1943), is most often seen in children and is said to be commoner in those with poor social backgrounds and in non-European communities in Africa and America (Miller et al., 1963). The lesion is usually seen in one eye but may occur in both either simultaneously or successively. It begins with irritation, lachrymation or photophobia. The characteristic finding is ofa small 1-3 mm shiny yellowish or grey bleb at the limbus with a sheaf of 29
....- I ._. J f(fuew0/£iteroture dilated vessels runmng out towards it from the edge ofconjunctival sac (Seaton, 1989). 5) Bronchiectasis Distention by mucus, caseous tissue or secondary infection beyond a bronchial stenosis may result in bronchiectasis, especially following lobar or segmental lesions (Roberts and Blair, 1950). The incidence is reduced by prompt chemotherapy and by the use ofcorticosteriod drugs (Gerbeaux et al., 1965). 6) Broncholith Calcification III a pnmary focus, or more commonly in a lymph node, may later be extruded into a brorchus as a broncholith, which may declare itself with haemoptysis. Such broncholith may be seen through the bronchoscope, but are best left well alone (Leitch, 2000). 7) Pneumonitis / collapse: These radiological appearances are due to lobar or segmental consolidation/collapse, and are associated with enlarged tuberculous lymph nodes at the hilum. The middle lobe is most often affected. The radiographic appearances may be due to collapse, inflammatory exudation, caseous pneumonia or any combination of these. Collapse is produced either by pressure of the lymph node on the bronchus or by the spread of tuberculosis granulation tissue into the bronchus with resultant stenosis or by discharge of caseous material from the lymph node through the bronchial wall (Seaton, 1989). 30
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dilated vessels runmng out towards it from the edge <strong>of</strong>conjunctival sac<br />
(Seaton, 1989).<br />
5) Bronchiectasis<br />
Distention by mucus, caseous tissue or secondary infection beyond a<br />
bronchial stenosis may result in bronchiectasis, especially following lobar<br />
or segmental lesions (Roberts and Blair, 1950). The incidence is reduced<br />
by prompt chemotherapy and by the use <strong>of</strong>corticosteriod drugs (Gerbeaux<br />
et al., 1965).<br />
6) Broncholith<br />
Calcification III a pnmary focus, or more commonly in a lymph<br />
node, may later be extruded into a brorchus as a broncholith, which may<br />
declare itself with haemoptysis. Such broncholith may be seen through the<br />
bronchoscope, but are best left well alone (Leitch, 2000).<br />
7) Pneumonitis / collapse:<br />
These radiological appearances are due to lobar or segmental<br />
consolidation/collapse, and are associated with enlarged tuberculous lymph<br />
nodes at the hilum. The middle lobe is most <strong>of</strong>ten affected. The<br />
radiographic appearances may be due to collapse, inflammatory exudation,<br />
caseous pneumonia or any combination <strong>of</strong> these. Collapse is produced<br />
either by pressure <strong>of</strong> the lymph node on the bronchus or by the spread <strong>of</strong><br />
tuberculosis granulation tissue into the bronchus with resultant stenosis or<br />
by discharge <strong>of</strong> caseous material from the lymph node through the<br />
bronchial wall (Seaton, 1989).<br />
30
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