Tuberculosis

Nota:

• 2 billion people infected, 30 million active cases, 8 million new cases and 2 million deaths per year. In Australia, its' 5 deaths per 100,000 per year. Higher risk people are Aborigines and 1st-gen migrants. HIV/AIDS people also affected. Incidence equal in both sexes

Nota:

• Caused by introduction to mycobacterium tuberculosis. Produces no toxins but glycolipids and peptidoglycan makes it resistant to destruction by phagocytes. Control of infection depends on the host immune response IFN-y secretions by the CD4+ T-lymphocytes of the Th1 phenotype. Containment also determined by NO synthase. Maintenance of granulomas and containment of the organism is dependent on TNF-alpha.

Nota:

• Done with Mantoux Test, but dependent on host immunological status and BCG immunization. Not useful for detecting active disease. Radiological also useful. Sputum examination for "acid-fast" bacilli. Nucliec acid amplification test.