Primary Tuberculosis - Overview of Information

Primary tuberculosis develops as a result of the first penetration of mycobacteria tuberculosis into the human body. The outcome of primary infection is determined by the number and virulence of mycobacteria, the duration of their exposure and, to a large extent, the immunobiological state of the body. Due to the high level of natural human resistance to tuberculosis infection, 90-95% of those infected with mycobacteria do not develop tuberculosis. In them, it occurs latent in the form of small specific changes with the formation of stable anti-tuberculosis immunity.

In immunocompromised individuals who have not been vaccinated with BCG or who have been vaccinated incorrectly, primary infection with Mycobacterium tuberculosis may result in the disease.

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Primary tuberculosis: epidemiology

In the conditions of a tense epidemic situation, infection with Mycobacterium tuberculosis occurs more often in children and adolescents and much less often in older age. Primary tuberculosis is rarely observed in middle-aged and elderly people. Various clinical forms of primary tuberculosis are detected in 10-20% of children and adolescents and less than 1% of adults who have contracted tuberculosis. In general, primary tuberculosis is diagnosed in 0.8-1% of newly diagnosed patients.

What causes primary tuberculosis?

Primary tuberculosis is characterized by damage to the lymph nodes, lungs, pleura, and sometimes other organs: kidneys, joints, bones, peritoneum. The area of specific inflammation can be very small and remain hidden during examination. With a large volume of damage, it is usually detected during clinical and radiological examination of the patient.

There are three main forms of primary tuberculosis:

• tuberculosis intoxication;
• tuberculosis of the intrathoracic lymph nodes;
• primary tuberculosis complex.

Symptoms of primary tuberculosis

Clinical symptoms of primary tuberculosis can be conditionally combined into three main syndromes: intoxication, bronchopulmonary-pleural, and syndrome of damage to other organs and systems.

Intoxication syndrome is caused by metabolic and functional disorders that occur in primary tuberculosis. Early clinical symptoms of tuberculosis intoxication are functional disorders of the central nervous system (irritability, emotional lability), vegetative-vascular dysfunction (tachycardia, arrhythmia, tendency to hypotension, systolic murmur over the apex of the heart), loss of appetite, increased sweating. Often, tolerance to physical and mental stress is reduced, as is the ability to concentrate.

Complications of primary tuberculosis

Primary tuberculosis may have complications with the deepening of disorders in the immune system and are associated with lymphohematogenous and bronchogenic spread of infection, as well as with the formation of destruction in the affected area and the generalization of the pathological process. The development of complications is facilitated by late diagnosis of primary tuberculosis, untimely initiation of treatment and failure to comply with the basic principles of therapy, most often complications occur in infants and preschool children.

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Diagnosis of primary tuberculosis

Due to the objective difficulties of bacteriological diagnostics in local forms of primary tuberculosis, X-ray examination acquires special significance, the informativeness of which largely depends on the methodology and technology. Sometimes, in patients with clinical signs of the disease and a turn in sensitivity to tuberculin, no pathological changes are detected on survey X-rays in two projections and on longitudinal tomograms of the chest organs. Only a slight expansion of the shadow of the root of the lung, a decrease in its structure, and an increase in the root pulmonary pattern are noted.

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