Tuesday, October 17, 2006

Tuberculosis and Cavities

The major site of infection of tuberculosis is the lungs. Tuberculosis causes the lymph nodes in the lung to enlarge, can appear like pneumonia, can cause extensive scarring, and even cause part of the lung to cave in and form cavities.

Cavitary lung disease from any cause is considered quite dangerours because of the destruction of lung tissue and also due to the fact that the cavities contain pus and bacteria.

When I listened to the lung of this little girl, I could hear hollow sounds over the cavity which are called amhoric, like the sounds made by blowing across the mouths of jars used in antiquity (amphora). When my stethescope moved slightly away from the cavity, the hollow sound disappeared. This is different than tubular breath tones heard in areas of consolidation like pneumonia without a cavity.

This girl would be considered infectious for tuberculosis because the cavity can contain more tuberculosis germs and she can spread them with a cough or just talking to someone. As a rule, children are not considered transmitters of tuberculosis. Identifying a pediatric tuberculosis case in the community means that there is an unidentified adult(s) that is/are spreading the disease.


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