3. Diagnosis

ByMR.RAGAVENDRAN

MEDICAL HISTORY

MICROBIOLOGICAL EXAMINTION SPUTUM COLLECTION

SLIDE PREPARATIONZiehl-Neelsen staining

MICROSCOPIC VIEW OF M .tuberculosis

CRITERIA FOR TUBERCULOSISDIAGNOSIS

NO OF NO OF BACILLIBACILLI

NO OF OIL NO OF OIL IMMERSION IMMERSION FIELDS SEENFIELDS SEEN

RESULTRESULT

00 100100 00

1-91-9 100100 scantyscanty

10-9910-99 100100 1+1+

1-101-10 11 2+2+

>10>10 11 3+3+

CLASSIFICATION OF PATIENTSSMEAR SMEAR POSITIVEPOSITIVE

INDETERMINAINDETERMINATETE

SMEAR SMEAR NEGATIVENEGATIVE

FALSE POSITVERed stain retained by scratches in slideAccidental transferContaminaton from environmental

mycobacteria

FALSE NEGATIVEPROBLEMS IN 1) collecting 2) processing 3) interpreting 4) administrative errors

FLUORESCENT MICROSCOPYrhodamine auramine

WITH ACRIDINE ORANGE DYE

CULTUREsolid medium

A SLOW GROWING NONPIGMENTED , NIACIN POSITIVE ACID FAST BACILLUS is taken as M.tuberculosis

CULTUREliquid medium

PCRCommonly used target for detection of

M.tuberculosis is the insertion sequence IS6110

USES 1)verify diagnosis by microscopy 2)identify genetic modifications

associated with resistance

CHEST X RAY

LUL CAVITY

Conslidation of RUL

PLEURAL EFFUSION right side

MASS MINIATURE RADIOGRAPHYabreugraphy

MANTOUX TEST

FALSE POSITIVEATYPICAL

MYCOBACTERIABCG VACCINE

FALSE NEGATIVE

DIAGNOSIS OF TUBERCULOUS MENIGITIS

DIAGNOSIS OF MILIARY TUBERCULOSISBone marrow biopsyLiver biopsyBlood Pus from tuberculous abscess

MILIARY TUBERCULOSISinterstitial nodules of uniform size and sharp edges

CT SCAN FOR MILIARY TB

RENAL TUBERCULOSISSTERILE PYURIASONOGRAMCALCIFICATIONS IN THE RENAL PELVIS

POTT’S DISEASE

Tb lymph node