| Abstract | Introduction: Studying tuberculids is difficult because of sporadic cases reports, lack of bibliographic,and spontaneous remission in some cases. Aim: Differentiate tuberculids to extrapulmonary tubercu- losis (TB). Discussion: Differentiate tuberculids to extrapulmonary tuber- culosis concerning definition,pathogenesis, clinical Definition: Tuberculids is presentation,diagnosis and treatment. a hypersensivity reaction to Mycobacterium tuberculosis antigens rele- ased from a distant focus of infection without promoting disea- se. Less than 1% of infected patients will develop into hypersen- sivity. Tuberculosis (TB) is a chronic contagious infectious disease caused by Mycobacterium tuberculosis. About 10 to 20 % of infected Pathogenesis and Immunity - Al- patients will develop into TB. lergy-Immunity Binomial - Rich's Formula: Tuberculids is ex- plained by mediated hypersensivity and in Poncet's disease can be considered Molecular Mimicry and Heat Shock Proteins(HSP). Rich's Formula: There is an insignificant number of bacillus and as a result its number and virulence tend towards null. Hypersen- sivity is exacerbated and immunity remains unchanged. TB- Tce- ll mediated immunity. Rich s Formula: elements propitious to bacilli, including number and virulence and host hypersensivity predominate on favourable conditions to host, as resistance and immunity. Clinical Manifestations: Tuberculids are limited to ocular(most usual) and rheumatologic (Poncet's disease) and der- matologic manifestations. Pulmonary TB is the most usual pre- sentation. There are also extrapulmonary manifestations and pleu- Diagnosis: ral TB is the most frequent extrapulmonary form. The tuberculids diagnosis can always be considered as exclusion one. It is important to separate tuberculids to other diseases. Se- rology is negative and chest X-ray is normal at tuberculids. Most patients are characterized by displaying a markedly positive tu- berculin skin test, evidence of past tuberculosis or contact of pacients with tuberculosis. There is an effective result to treat- ment including tuberculin desensitizing therapy. Patients with pulmonary tuberculosis present clinical symptoms, chest X-ray suggested of TB infection and demonstration of Acid Fast Baci- lli on sputum smear. The definitive diagnosis depends on reco- very of Mycobacterium tuberculosis from culture. Extrapulmonary forms present symptoms concerning to peculiar system affected and Acid Fast Bacilli on secretions, demonstrating lack of baci- llus. Histopathology of samples reveals granuloma and caseous Treatment: In tuberculids it can necrosis with or without bacilli. be used mainly tuberculin desensitizing therapy, anti-TB agents and corticosteroids. In TB is recommended treatment anti-TB regimens and in some cases of extrapulmonary TB it can be added corticosteroids. Conclusion: Tuberculids is not TB. Comparably, they are different expressions of Mycobacterium tuberculosis that causes mainly tuberculosis infection and also provokes hypersensi- vity reaction so harmfull as TB disease. Key-words: tuberculids, tuberculosis, comparison. |
| Authors | Jcb Pereira
(Affiliation: Hospital Municipal Nelson de Sá Earp-Petrópolis e Serviço de Atendimento Especializado da SMS-Belford Roxo -Rio de Janeiro, Brasil.)
|
| Journal | Revista portuguesa de pneumologia
(Rev Port Pneumol)
Vol. 12
Issue 6 Suppl 1
Pg. 31-2
(Dec 2006)
ISSN: 0873-2159 Portugal |
| Vernacular Title | Análise comparativa entre tuberculides e tuberculose extrapulmonar - Uma outra face do Mycobacterium tuberculosis. |
| PMID | 17206336
(Publication Type: English Abstract, Journal Article)
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