Classification of pulmonary tuberculosis

Until the twentieth century, tuberculosis was considered a disease incurable. A person suffering from this ailment was doomed. In our time, I want to have hope that this disease is over. But this is not so. Annually around the world about nine million people are infected with tuberculosis, especially in underdeveloped countries. More than two million people die from it.

Infected, as a rule, by airborne droplets, and this is due to the amount of harmful bacteria in the air.

Classification of tuberculosis depends on its form, clinical picture, prevalence and so on. We will discuss this problem in more detail below.

Classification adopted in Russia

The classical clinical classification of tuberculosis according to VA Koshechkin and ZA Ivanova is based on the following indices:

• Clinical features of the disease process;
• Its localization and prevalence;
• Phase of flow;
• Development mechanisms;
• The presence of bacterial secretions.

It consists of four sections:

1. Clinical forms.
2. Characteristics of the disease process.
3. Complications after illness.
4. Changes in the body after recovery.

This classification has been used in Russia since the thirties.

Clinical forms

The forms of clinical manifestation depend on the location of the disease and its signs, taking into account the pathogenetic characteristics of the disease process. It is accepted to distinguish between children's intoxication with tuberculosis, tuberculosis of the respiratory organs (lungs, bronchi of the trachea), lymph nodes, CNS and brain membranes, intestines and peritoneum, joints and bones, organs of the genitourinary system, skin, eyes, and other organs.

The clinical classification of pulmonary tuberculosis includes such ailments as primary tuberculosis, disseminated, miliary, also focal, infiltrative, caseous pneumonia, pulmonary tuberculoma. This includes cavernous, fibrous-cavernous, cirrhotic tuberculosis, as well as empyema. Let us consider in more detail each of them, since they have special significance in phthisiology.

Primary tuberculosis

This disease occurs when bacteria are infected with previously infected people, in which a positive reaction to tuberculin is observed for the first time. In this case, the infection penetrates into the lymph nodes and causes their inflammation. The disease may not show symptoms or, on the contrary, demonstrate acute inflammation in the lungs.

Disseminated tuberculosis

The disease is characterized by the appearance of a large number of lesions in the lungs, which acts as an inflammation caused by lymphogenous microorganisms.

Disseminated tuberculosis is acute, chronic and generalized. Most patients get worse, but a small proportion of people find the disease only after passing the fluorography.

Focal tuberculosis

Classification of pulmonary tuberculosis explains focal tuberculosis as lung lesions, which 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. Focal tuberculosis may be fresh or chronic. Symptoms this ailment may not manifest, so it is often also detected only when performing fluorography.

Infiltrative tuberculosis

This ailment combines processes that represent several foci with inflammation, which extends to the lobe of the lung and progresses.

Infiltrative tuberculosis can be round, cloud-like, broncho- lobular, and can be manifested as a lobit (a vast infiltrant that occupies a whole fraction). Often such tuberculosis takes place under the guise of other diseases, therefore it is recommended to perform fluoroscopy and sputum analysis of the patient.

Pneumonia, caseous

The ailment is characterized by the presence of necrotic zones in the lungs, which are prone to cavitation. This form of tuberculosis is the heaviest, since it has a sharp progressive course. It is lobar and lobular.

The disease begins sharply, the organism becomes intoxicated, purulent sputum appears with blood impurities. Diagnosis is difficult in the first days of the illness, 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, regressing and progressing. The ailment is characterized by the presence of dense inclusions or single foci in the surrounding tissues.

Cavernous tuberculosis

The disease is characterized by the presence of an air cavity without inflammation in the walls and tissues of the lungs. If all this is accompanied by a pronounced fibrosis with multiple foci of seeding, then such tuberculosis is called fibrous-cavernous. This process is chronic.

Allocate a limited and widespread form 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, caverns 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 inflammatory processes 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 arises from complications of tuberculosis. There are such forms:

• Dry pleurisy;
• Exudative pleurisy;
• Empyema.

Classification of pulmonary tuberculosis explains the ailment as an inflammation that spreads into the cavity of the pleura, causes intoxication and accumulation in the pleural cavity of the fluid.

Characteristics of the disease process

The classification of clinical forms of tuberculosis according to the characteristics of its process depends on the presence or absence of MBT (mycobacteria) in the study material taken from the patient. Here we take into account both the duration of the disease process and the location of the affected areas. Pay attention also to the presence of seals and scarring on the affected areas.

Complications

In the role of complications, which can cause the disease, the following points appear:

• Spitting blood;
• Bleeding in the lungs;
• Sudden pneumothorax;
• Fistula formation;
• Atelectasis;
• Pulmonary, renal and heart failure;
• Amyloidosis and others.

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 of tuberculosis, changes in some organs may occur. So, it can be revealed:

• The presence of calcification in the lymph nodes and lungs,
• Cirrhosis,
• Fibrotic, dystrophic and other changes in the respiratory system.

And also the presence of scars on different organs, their calcification and so on.

Classification of Turban - Gerhard

At the beginning of the last century, the classification of Turban-Gerhard, based on the theory of the progression of pulmonary tuberculosis, was recognized. It is considered quite simple and highlights the role of the spread of the disease for the further prognosis of tuberculosis.

But over time this theory was refuted and another classification of tuberculosis began to be used. Tubran and Gerhard believed that first the disease affects the upper parts of the lungs (the first stage of the disease), then it goes to the middle divisions (the second stage), 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 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).

The classification of tuberculosis corresponds to the international classification of diseases, denoted by numbers. For example, the code A15-A16 means a disease of respiratory tuberculosis.

In some countries, the classification of tuberculosis is used, where destructive and non-destructive forms of tuberculosis are identified. With the first form, the necrotic layer grows, which can move to the layer of the lung tissue. There are foci of pneumonia, changes in the bronchi. So, destructive forms include cavernous, cirrhotic and fibrous-cavernous tuberculosis.

Thus, tuberculosis is today 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.