Until the twentieth century, tuberculosis was considered to be an incurable disease. The person suffering from this disease was doomed. In our time, I want to have hope that this disease is over. But it's not. Around nine million people worldwide become infected with TB every year, especially in underdeveloped countries. More than two million people die from it.
They are usually infected by airborne droplets, and this is due to the amount of harmful bacteria in the air.
Classification of tuberculosis depends on its form, clinical presentation, prevalence and so on. We will consider this problem in more detail below.
Classification adopted in Russia
The classical clinical classification of tuberculosis according to V. A. Koshechkin and Z. A. Ivanova is based on the following indicators:
- clinical features of the disease process;
- its localization and prevalence;
- flow phases;
- development mechanisms;
- presence of bacteriological secretions.
It consists of four sections:
- Clinical forms.
- Characteristic of the processdiseases.
- Complications after illness.
- Changes in the body after recovery.
This classification has been used in Russia since the thirties.
Clinical Forms
The forms of clinical manifestations depend on the location of the disease and its symptoms, taking into account the pathogenetic characteristics of the disease process. It is customary to distinguish childhood intoxication with tuberculosis, tuberculosis of the respiratory organs (lungs, tracheal bronchi), lymph nodes, central nervous system and membranes of the brain, intestines and peritoneum, joints and bones, organs of the genitourinary system, skin, eyes, and other organs.
Clinical classification of pulmonary tuberculosis includes such diseases as primary tuberculosis, disseminated, miliary, also focal, infiltrative, caseous pneumonia, pulmonary tuberculoma. This also includes cavernous, fibrous-cavernous, cirrhotic tuberculosis, as well as empyema. Let us consider each of them in more detail, as they are of particular importance in phthisiology.
Primary TB
This disease occurs when previously uninfected people are infected with bacteria, in which a positive reaction to tuberculin is observed for the first time. In this case, the infection penetrates the lymph nodes and causes them to become inflamed. The disease may not show symptoms or, conversely, show acute inflammation in the lungs.
Disseminated TB
The disease is characterized by the appearance in the lungs of a large number of lesions, which acts asinflammation caused by lymphogenous microorganisms.
Disseminated tuberculosis is acute, chronic and generalized. Most of the sick people feel worse, but a small part of people discover the disease only after undergoing a fluorography.
Local TB
Classification of pulmonary tuberculosis explains focal tuberculosis as lung lesions that arose for the first time against the background of the development of other forms of this disease and are expressed in productive inflammation of the respiratory organ. There is focal tuberculosis fresh or chronic. This ailment may not show symptoms, therefore it is often also detected only during fluorography.
Infiltrative tuberculosis
This ailment combines processes that are several foci with inflammation that spreads to the lobes of the lung and progresses.
Infiltrative tuberculosis is round, cloudy, broncholobular and may present with lobitis (extensive infiltrate occupying an entire lobe). Often, such tuberculosis occurs under the guise of other diseases, so it is recommended to conduct x-rays and analyze the patient's sputum.
Caseous pneumonia
The disease is characterized by the presence of necrotic zones in the lungs, which are prone to cavernization. This form of tuberculosis is the most severe, as it is characterized by an acute progressive course. It can be lobar and lobular.
The disease begins acutely, intoxication of the body occurs, purulentsputum with blood impurities. In the first days of the disease, diagnosis is difficult, since a negative reaction to tuberculin is detected.
Tuberculoma
Classification of forms of pulmonary tuberculosis explains tuberculoma as a disease with an asymptomatic picture and a chronic form of the course. It can be stable, regressive and progressive. The disease is characterized by the presence of dense inclusions or single foci in the tissues surrounding the lungs.
Cavernous tuberculosis
The disease is characterized by the presence of an air cavity without inflammation in the walls and tissues of the lungs. If a pronounced fibrosis with multiple foci of seeding joins all this, then such tuberculosis is called fibrous-cavernous. This process is chronic.
There are limited and widespread forms of the disease. Cavernous tuberculosis is a consequence of the treatment of other forms of the disease and is asymptomatic.
Cirrhotic tuberculosis
The disease is characterized by massive fibrosis of the lungs, where healed and active foci, cavities are observed. Periodically, the disease worsens in the form of inflammation of the lungs and bronchi. Cirrhotic tuberculosis is limited and diffuse. The disease provokes respiratory failure and inflammation in the respiratory system. There are seals in the connective tissue of the lungs.
Pleurisy
This disease is an acute inflammation of the pleura, which has a chronic form and occurs as a result of complications of tuberculosis. The following forms are distinguished:
- dry pleurisy;
- exudative pleurisy;
- empyema.
Classification of pulmonary tuberculosis explains the named ailment as an inflammation that spreads in the pleural cavity, causes intoxication and accumulation of fluid in the pleural cavity.
Characterization of the disease process
Classification of clinical forms of tuberculosis according to the characteristics of its process depends on the presence or absence of MBT (mycobacteria) in the test material taken from the patient. Here, both the duration of the disease process and the location of the affected areas are taken into account. Pay attention also to the presence of seals and scarring in the affected areas.
Complications
The following points act as complications that the disease can cause:
- spitting blood;
- bleeding in the lungs;
- sudden pneumothorax;
- fistula formation;
- atelectasis;
- pulmonary, renal and heart failure;
- amyloidosis and more.
These manifestations can accompany the disease at all stages of its development, it all depends on the patient's immunity.
Changes after illness
After curing tuberculosis, changes in some organs may be observed. So, it may show up:
- presence of calcifications in the lymph nodes and lungs,
- cirrhosis,
- fibrotic, dystrophic and other changes in the respiratory organs.
As well as the presence of scars on different organs, their calcification and so on.
Classification of Turban - Gerhard
At the beginning of the last century, the Turban-Gerhard classification was recognized, which is based on the theory of the progression of pulmonary tuberculosis. It is considered quite simple and emphasizes the role of the spread of the disease for the further prognosis of tuberculosis.
But over time, this theory was refuted and a different classification of tuberculosis began to be used. Tubran and Gerhard believed that the disease first affects the upper sections of the lungs (the first stage of the disease), then it moves to the middle sections (the second stage), and subsequently affects the entire organ (the third stage).
Modern classification of tuberculosis
In our time, it is customary to use the international classification of tuberculosis, which is constantly being improved. According to her, different types of tuberculosis are indicated by code combinations consisting of letters and numbers. It was adopted in 1973 and consists of four parts (A, B, C, D).
Classification of tuberculosis corresponds to the international classification of diseases, indicated by numbers. For example, the code A15-A16 denotes a disease of respiratory tuberculosis.
In some countries, a classification of tuberculosis is used, where its destructive and non-destructive forms are distinguished. In the first form, the necrotic layer increases, which can pass to the layer of lung tissue. There are foci of pneumonia, changes in the bronchi. So,destructive forms include cavernous, cirrhotic and fibrous-cavernous tuberculosis.
Thus, tuberculosis today is a particularly dangerous disease that is transmitted from an infected person by airborne droplets. The disease has several forms and classifications. It can be acute or asymptomatic and lead to various complications and even death.
