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Primary Tuberculosis - Complications
Last reviewed: 23.04.2024
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Complications of primary tuberculosis occur with deepening of disorders in the immune system and are associated with lymphogematogenic 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. 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.
Typical complications of primary tuberculosis: pleurisy, lymphohematogenous and bronchogenic dissemination, atelectasis with subsequent development of inflammatory and cirrhotic changes, bronchus tuberculosis, nodulobronchial fistula, and primary cavern in the lung or lymph node.
Quite serious, but infrequent complications of primary tuberculosis are now caseous pneumonia and tuberculous meningitis. Rarely observed complications such as compression of enlarged lymph nodes of the trachea, esophagus, vagus nerve, perforation of the caseo-necrotic node into the lumen of the thoracic aorta.
[Lymphohematogenous dissemination
Lymphohematogenous dissemination leads to the appearance of fresh tuberculosis foci in the lungs, which is rarely accompanied by vivid clinical symptoms. With the progression of the inflammatory reaction in the focal zone, the symptoms of intoxication and signs of local damage to the respiratory system are intensified. When X-ray examination focal shadows are localized in the upper parts of the lungs. In the process of reverse development, an increase in the intensity of the shadows, a decrease in their size is observed, while the contours of the shadows become more clear. Sometimes the inclusion of calcium salts is detected. Such foci-dropouts in the tops of the lungs are usually called the foci of Simon.
Atelectasis of the lungs
Violation of bronchial patency with the development of atelectasis can be suspected in the presence of persistent symptoms of intoxication, chest pain, dry cough, and also with the appearance of signs of respiratory failure. The nature and severity of clinical symptoms depend on the caliber of the affected bronchus and the rate of atelectasis development. When viewed above the airless zone, sometimes there is a tendency to become adorned or flattened in the chest, and the lagging behind the affected side when breathing. The percussion sound above the atelectasis zone is muffled, breathing and voice trembling are weakened, and occasionally dry rhonchuses are heard. Radiographic examination determines a uniform darkening with distinct, sometimes concave contours. The atelectasized proportion of the lung is reduced in volume, so the root of the lung and the mediastinum are biased towards the lesion. Other parts of the lung can be excessively transparent due to increased airiness.