结核病-结核总论.pptVIP

: enlargement of infected aeras and appear newer infiltrated regions or spreading. There are direct smear and culture ，Direct smear examination is only positive when large numbers of bacilli begin to be excreted，A negative smear by no means excludes tuberculosis A negative smear in the presence of extensive disease and cavitation makes the diagnosis less likely. Particularly if the negatives are frequently repeated In practice the white blood count is only useful in a minority of cases, When the patient is less ill and the radiological shadowing less extensive the count is often normal or high normal Since it is not possible to identify which patients still have dormant bacilli, all patients should continue their treatment until the end of the prescribed period, to limit the number of relapses. Diagnosis depends on: 1. Careful history History of TB contact History of vaccination TB toxemia：fever, poor appetite, loss of weight, weakness and fatigue History of contagion Diagnosis depends on: 2. TB examination: smear or culture sputum,gastric juice,cerebrospinal fluid Bacteriological Confirmation -golden standard * 3.The presence of three or more of the following should strongly suggest a diagnosis of TB: Chronic symptoms suggestive of TB Physical signs highly of suggestive of TB A positive tuberculin skin test Chest X-ray suggestive of TB Diagnosis depends on: Primary tuberculosis Chest X-ray of TB Tuberculosis of bronchiallymphnodes Chest X-ray of TB 4. Other clues suggest a diagnosis of TB: PCR ELISA Biopsy Erythrocyte sedimentation rate(ESR) ESR is often elevate Diagnosis depends on: Appropriate Principle Combined Different -stage Full-termed Early Regular Treatment Treatment Most TB is curable, but… Four or more drugs required for the simplest regimen 6-9 or more months of treatment required Person must be isolated until non-infect