Primary Tuberculosis - Overview of Information

Primary tuberculosis develops as a result of the first penetration of mycobacterium 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 organism. Due to the high level of natural resistance of a person to tuberculosis infection, tuberculosis does not develop in 90-95% of infected mycobacteria. In them, it proceeds secretly in the form of small specific changes with the formation of stable antituberculous immunity.

In people with immunodeficiency, not vaccinated with BCG or vaccinated in violation of the rules, primary infection with mycobacteria tuberculosis can lead to the disease.

[1], [2], [3], [4], [5], [6], [7],

Primary tuberculosis: epidemiology

In conditions of a strained epidemic situation, infection with mycobacteria of tuberculosis occurs more often in children and adolescents and is much more rare - in older age. In people of middle and old age, primary tuberculosis is rarely observed. Different clinical forms of primary tuberculosis are revealed in 10-20% of children and adolescents and less than 1% of adults who have become ill with tuberculosis. In general, primary tuberculosis is diagnosed in 0.8-1% of newly diagnosed patients.

What causes primary tuberculosis?

Primary tuberculosis is characterized by involvement of lymph nodes, lungs, pleura, and sometimes in other organs: kidneys, joints, bones, peritoneum. The zone of a specific inflammation can be very small and remain hidden during the examination. With a large amount of damage, it is usually found during clinical and radiation examinations of the patient.

There are three main forms of primary tuberculosis:

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

Symptoms of primary tuberculosis

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

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

Complications of primary tuberculosis

Primary tuberculosis may have complications in deepening the disorders in the immune system and are associated with lymphohematogenous and bronchogenic spread of the 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 non-adherence to the basic principles of therapy, the most common complications occur in infants and preschool children.

[8], [9], [10], [11], [12], [13],

Diagnosis of primary tuberculosis

In connection with the objective difficulties of bacteriological diagnosis in the local forms of primary tuberculosis, an X-ray examination becomes particularly important, the informativeness of which largely depends on the methodology and technology. Sometimes, patients with clinical signs of the disease and a bias of sensitivity to tuberculin on the survey radiographs in two projections and on longitudinal tomograms of the chest organs do not detect pathological changes. Mark only a slight expansion of the shadow of the root of the lung, a decrease in its structure, an increase in the basal pulmonary pattern.

[14], [15], [16], [17], [18]