Destructive (cavernous) tuberculosis

Description:

Cavernous pulmonary tuberculosis — a pulmonary tuberculosis form at which cavities are found. Develops when progressing of other forms (primary complex, the focal, infiltrative, hematogenous disseminated tuberculosis) leads to formation of a cavity, that is a resistant cavity of disintegration of pulmonary fabric. Proceeds without the centers of elimination and without development of a perifocal inflammation.

At this disease the cavity represents a pathological cavity, limited to the three-layered capsule which inside layer consists of not torn away caseous masses, the center — a layer of specific granulations, a periblast — a fibrous layer.

Symptoms of Destructive (cavernous) tuberculosis:

For cavernous tuberculosis a typical symptom complex is "the disintegration phase syndrome":

    * cough with existence of a phlegm,
    * rattles in lungs,
    * pneumorrhagia,
    * bakteriovydeleniye.

Reasons of Destructive (cavernous) tuberculosis:

In most cases this form of a disease is a consequence of infiltrative tuberculosis. Initially infiltrate includes focus of an inflammation in which center there is caseous masses (nekrotizirovanny pulmonary fabric), and in perifocal infiltrate — a large number of lymphocytes, leukocytes and macrophages. As a result of death of these cells a large amount of proteases which with ease melt caseoses is released. Liquid caseoses begins to follow through the draining bronchial tube, and the disintegration cavity is formed. The diagnosis infiltrative tuberculosis in a disintegration phase is in that case exposed. During treatment perifocal infiltration around a zone of disintegration begins to resolve and there is a cavity about which there are always elements of a productive inflammation which are constantly transformed to caseous fabric. The cavity forms at a rassasyvaniye of a perifocal inflammation and fibrosing.

Other option of a pathogeny — transformation of a tuberkuloma in a cavity.

Emergence of a cavity changes characteristics of tubercular process in the adverse party. Conditions for a bronchogenic drift of the infected phlegm from a cavity through the draining bronchial tube in healthy departments of lungs are created. Healing of a cavity is complicated because the elastic energy of a lung or inflammatory consolidation in its circle prevent healing of a cavity and keep availability of the air in it arriving under pressure through the draining bronchial tube at deep breaths and cough. The carrier of a cavity allocates tubercular mycobacteria with a phlegm.

Radiological at cavernous tuberculosis the enlightenment of rounded shape with a clear boundary which is located among focal fabrics in the center of a shadow of infiltrate or within the capsule of the former tuberkuloma depending on what form of tuberculosis preceded emergence of a cavity is found. Less often the cavity is defined separately, on the open pulmonary floor, without existence in lungs of other changes of tubercular character. It happens at a full vykrashivaniye tuberkuloma caseose from the isolated tuberkuloma or at total disintegration of the isolated infiltrate.

Treatment of Destructive (cavernous) tuberculosis:

Treatment is carried out by antitubercular drugs in a hospital or sanatorium not less than three drugs for a year and more (before healing).