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TUBERCULOSIS

TUBERCULOSIS. Sri Chusniati. TUBERCULOSIS. G : Mycobacterium F : Mycobacteriaceae O : Actinomycetales. Morphology & characteristics:. Slender, straight or slightly curved rod with rounded ends Width from 0.2 – 0.5 um, length 1.5 – 4 um Acid-fast

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TUBERCULOSIS

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  1. TUBERCULOSIS Sri Chusniati

  2. TUBERCULOSIS G : Mycobacterium F : Mycobacteriaceae O : Actinomycetales

  3. Morphology & characteristics: • Slender, straight or slightly curved rod with rounded ends • Width from 0.2 – 0.5 um, length 1.5 – 4 um • Acid-fast • Non spore & non capsulated • Non motile • Obligate aerobe • Intra cellular • Gram +

  4. Growth Properties in media Media: • Not grow in general medium • Grow In rich medium + albumin (Lowenstein Jensen) Period incubation 4-6 weeks at temperature of 37o C Colonies: Dried, rough, convex color: white to yellow (M. tuberculosis) wet, flat, smooth white in color (M. bovis) In broth medium: grow spreading on the wall of the tube from the bottom to the top & form membrane in surface

  5. Media for the growth of Mycobacterium: - Lowenstein Jensen (glycerol) - Stonebrink (M. bovis) - Egg yolk Citrate - Potato Agar - Petragnani - Dubos Broth colonies appear after 4 – 6 weeks

  6. Characteristics in biochemistry tests • Mycobacterium bovis not form niacin & non reduce nitrate • This properties are contrariwise with Mycobacterium tuberculosis

  7. Resistances • Sun rise directly in + 8 ours • Pasteurize • Suspension of cresol/phenol 5 %: 24 ours • Jodium tincture: 5 minutes • Resistant to 4% NaOH • Resistant In rotten carcass & wet soil for 1-4 years • In dried feces of cattle bacteria are able to life in 150 days

  8. Sensitive host cattle, poultry and human • M. bovis M. tbc tipe bovis • M. avium M. tbc tipe avium • M. tuberculosis M. tbc tipe human contagious chronic zoonoses The type of disease are acute & progressive to all organs

  9. TUBERCULOSIS (BOVINE)Bovine tuberculosis • The causative agent is Mycobacterium bovis • It occurs worldwide, but M. bovis has been almost eradicated from the cattle of several developed countries.

  10. Reservoir & mode of transmission • Cattle are the natural reservoir of infection • Transmission to humans is via consumption of row milk • The organism poses a serious hazard to laboratory workers Incubation period • Humans  four weeks to several years • Animal  variable

  11. Antigenic Structure Consisted of Polysaccharide, protein & lipid Clinical features Cattle chronic disease - Weight loss - Bronchopneumonia  extensive destruction of lung tissue  progressive respiratory distress  death. - Swelling of the retropharyngeal lymph node - Mastitis  progressive indurations

  12. Humans • The primary lesion  • enlarged cervical limph nodes • Over many months, with fever, weight loss, abdominal pain & tenderness, bone & joint lesions, meningitis with neurological sign.

  13. Pathogenesis • via inhalation  lung  cough  be swallowed  gut  intestine  hematogen/lymphogen >< phagocyte cells  multiply  damage phagocyte cells  form mass like cheese • The injured cell stimulate the body to form epitheloid cells (to localize bacteria so the bacteria are able to spread continuously)  giant cell • At tubercle calcium are piled or heaped  to be a thing like lime

  14. In resistance animals • Tubercle not develop  just appear in the local area named local tuberculosis (tbc lokal)

  15. In sensitive animals Tubercle become enlargement. In bronchus tubercle become erupts during animal coughing  bacteria enter GIT  and continuously spread to entire body through lymphogen/ hematogen until reach wall of intestine, liver, spleen, lung, udder, uterus  general tuberculosis (tbc umum/milier) When bacteria of M. tbc are found in milk, urine and sputum, the disease named tbc terbuka

  16. Fowl • Avian tbc occur depend on environmental • sanitation • Infection occur through oral and inhalation • The process of tubercle formed in fowl • similar with the process in cattle • Predilection organs : intestine, liver, spleen, • bone marrow. • The disease unusual attack lung

  17. Tuberculin Test • Clinical features • Pathology changes • Lab examination Diagnosis:

  18. Tuberculin test Generally intra dermal Methods: Shear the feather, measure the thickness of cowhide with cutimeter  injection tuberculin Observation after 72 hours. Result:Fever, Increasing of cowhide thickness > 60%  + < 60%  -

  19. Pathology: • Tubercle with variated size, one/joined • If cut feels like cutting sand center of cheese-like form • Tubercle esp. in lung, hepar, spleen, ren, retropharyngeal lymph nodes, bronchiale lymph nodes, mesenteric lymph nodes • Giant cell, epitheloid cell

  20. Lab examination Sample (sputum, urine, cerebrospinal fluid, pus) • If organ + papain  + NaOH 2-4%  wait for 30’ centrifuge  sediment + HCl 2N  culture & incubation 37oC in 5-8 weeks if 12 weeks not growing  negative Followed by microscopic  BTA animal-tested

  21. Biologic Test : • Colony centrifuged  sediment + PZ  injected to 2 animal (sc/ip) • Animal weak & bulge on injection area • After approximately 4 weeks  1 animal killed  PA/ negative After 8 weeks 1 animal killed  PA/ PA/  tubercle in organs

  22. Result of biologic test: Fowl Guinea pig Rabbit M. bovis - + + M. avium + - + M. tbc - + -

  23. Differential Diagnosis Cattle: • Pleuro Pneumonia Contagiosa Bovis c/ Mycoplasma bovis • Aspirasi Pneumonia • Corynebacterium pyogenes • Malleusc/ Pseudomonas mallei • Johne’s disease c/ M. paratbc

  24. Fowl: • Neoplasma • Aspergllosis, Mucormycosis • Penyakit pernafasan causa lain • Penyakit pencernakan causa lain

  25. Testing material & shipping method • Sputum, pleural fluid, raw milk, organ  fresh & cool, in transport media • organ  in formalin 10%  histopathology

  26. Prevention & Controlling: Animals: • No Vaccination • Sanitation disinfectant liquid cresol/phenol • Isolation suspect animals • New animal from tbc-free places • Serious condition slaughtered Good condition may be cut & look after part with tubercle must be thrown away

  27. Fowl • Good management • Sanitation • New animals from tbc-free area • Reactors tuberculin + slaughtered • Prevent domestic birds transmission

  28. Treatment Usually failed because : • Cell wall of bacteria is thick • Bacteria can live by intracellular • Drugs penetration is slow Animals: • Not attempted Humans: • antituberculous chemotherapy

  29. Health aspect: • Cattle Local tbc : consume only the sterilized milk throw infected organ away general tbc /milliar: slaughter & throw away

  30. Thank you

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