Pneumonia And Pulmonary Tuberculosis

PNEUMONIA

Terminologies used

Lung Consolidation: Is a radiological term describing an area of increased lung density, often caused by fluid, cells, or other material filling the alveoli (tiny air sacs in the lungs).

It appears with homogenous opacity, Air bronchograms, which are visible air-filled airways surrounded by consolidated tissue, are a key characteristic of consolidation.

Pneumonia is by far the commonest cause of an area of CXR consolidation.

Pneumonia And Pulmonary Tuberculosis

Air bronchogram sign: Is a radiographic sign of consolidation, characterized by black lines within a white, dense area of lung tissue, representing air-filled bronchi within consolidated lung.

Patch opaque shadows: also known as pulmonary opacities, represent areas where the X-ray beam is attenuated more than the surrounding lung tissue, resulting in a denser or whiter appearance on the image.

Bronchiectasis: an irreversible dilatation of the bronchial tree, may appear as tram tracks, ring shadows, or tubular opacities.

Peribronchovascular infiltrates: increased density or opacity along the pathways of the bronchi and blood vessels, often described as peribronchovascular thickening or consolidation.

SOB –

Note:

Empyema: a collection of pus within the pleural space, often appearing as a fluid density that may contain air-fluid levels Pleurisy: or pleuritis, is the inflammation of the pleura, the membrane lining the lungs and chest wall.

Bacteremia: Refers to the presence of bacteria in the bloodstream.

Pneumonia And Pulmonary Tuberculosis

The most frequent chest radiographic findings of COVID-19 pneumonia: Are Multifocal consolidation or ground-glass opacity (GGO), usually with bilateral, peripheral, and lower zone predominance.

Consider the followings

The CXR is excellent for detecting the presence and extent of most pneumonias. All the same, on the CXR, some pneumonias are furtive and secretive and do their best to hide.

Fortunately, there is help at hand – the silhouette sign. If you look for the silhouette sign, then you will be able to detect these hidden pneumonias.

Identify the type of pneumonia

PULMONARY TUBERCULOSIS

INTRODUCTION

Tuberculosis is an airborne infectious disease caused by bacteria called mycobacterium tuberculosis which primarily affect the lungs but can spread to other organs.

It is transmitted through airborne droplets when an infected person coughs or sneezes ,once inhaled the bacteria settle in the lungs and trigger the immune response leading to the granuloma formation.

CLINICAL FINDINGS

• A persistent cough (lasting longer than 3 weeks), often with blood or mucus
• Fatigue
• weight loss
• loss of appetite
• Fever
• night sweats

Additionally, some individuals may experience chest pain or shortness of breath.

Classifications of tuberculosis

The classifications of the tuberculosis it depends on the range of infections ,the following are the two categories of tuberculosis,(Patterns that raise the suspicion of PTB)

PRIMARY TB

POST PRIMARY TB

NOTE : MILIARY TB

PRIMARY TB

Primary TB refers to the initial infection with Mycobacterium tuberculosis, often occurring in previously uninfected individuals, typically in children.

It's characterized by the development of a "primary complex," which includes a lung lesion (usually a Ghon focus), lymphadenopathy in the hilar lymph nodes, and sometimes pleural effusion.

Radiologically, primary TB can manifest as parenchymal consolidation(may show air fluid level), hilar lymphadenopathy, miliary nodes and possible pleural effusion Ghon complex (a calcified granuloma) and a corresponding calcified lymph node can be seen in healed primary TB.

MOST COMMON RADIOLOGICAL FINDINGS IN PRIMARY TB.

1.Lymphadenopathy: the enlargement of lymph nodes near the hilum ,often appears as bulky or rounded opacity on the X rays.

• This is the most Common radiological manifestation of primary TB.
• 2.Lung consolidation

3.Possible pleural effusion

Primary TB(Lymphadenopathy)

POST- PRIMARY TB

Usually post primary tuberculosis is thought to results from the reactivation of infection with dormat tuberculosis(latent TB), The radiological findings of post primary TB .

Cavitary lesion (these are hollow spaces in lungs tissues due to bacteria destruction). Are frequently found in a consolidation area and can be multifocal.

Cavitation is typically findings in post primary tuberculosis ,seen on chest radiographs

PA chest radiograph showing patchy air spaces opacity(arrows) in right upper lobe with a cavity lesion(arrowheads),

Extensive shadowing, and some volume loss, in the right upper lobe. Post primary PTB

WHAT TYPE OF TB IS THIS

MILIARY TB

Refers to disseminated form where bacteria spread through the bloodstream causing tiny nodules through lungs.

This represents haematogenous spread of the bacilli. It is most commonly associated with primary PTB but it can occur with post-primary PTB.

The term “miliary” refers to the millet-seed appearance of the tiny nodules scattered throughout the lungs

Pneumonia And Pulmonary Tuberculosis

characterized by fibronodular changes in the apical and upper lung zones (numerous small pulmonary opacities that are generally uniform in size and widely distributed)

MILLIARY TB

GENERAL RADIOGRAPHIC FEATURES OF PULMONARY TB

Summarize the above findings

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