Post-tuberculosis lung disease

A chronic lung condition following tuberculosis infection

Post-tuberculosis lung disease (PTLD) refers to a spectrum of chronic pulmonary disorders that occur as a consequence of tuberculosis (TB) infection. These conditions can persist even after successful treatment of the initial TB infection, leading to significant morbidity.

Pathophysiology

Post-tuberculosis lung disease arises from the structural and functional damage caused by the Mycobacterium tuberculosis infection. The body's immune response to the bacteria can lead to the formation of granulomas, which are clusters of immune cells that attempt to wall off the infection. Over time, these granulomas can cause scarring and fibrosis of lung tissue.

An aspergilloma complicating tuberculosis

The healing process of TB can result in various forms of lung damage, including:

• Fibrosis: The formation of excess fibrous connective tissue in the lungs, leading to reduced lung elasticity and impaired gas exchange.
• Bronchiectasis: Permanent dilation of parts of the airways, which can lead to chronic infection and sputum production.
• Cavitation: The formation of cavities in the lung tissue, which can become sites for secondary infections such as aspergilloma.

Clinical Manifestations

Patients with post-tuberculosis lung disease may experience a range of symptoms, including chronic cough, sputum production, dyspnea (shortness of breath), and recurrent respiratory infections. The severity of symptoms can vary depending on the extent of lung damage.

Diagnosis

Diagnosis of PTLD involves a combination of clinical evaluation, imaging studies, and pulmonary function tests. Chest X-ray and CT scan are commonly used to assess the extent of lung damage and identify features such as fibrosis, bronchiectasis, and cavitation.

Healed tuberculous cavity

Management

Management of post-tuberculosis lung disease focuses on alleviating symptoms and preventing further lung damage. Treatment options may include:

• Bronchodilators: To help open the airways and improve breathing.
• Corticosteroids: To reduce inflammation in the lungs.
• Antibiotics: For treating secondary bacterial infections.
• Pulmonary rehabilitation: A program of exercise and education to improve lung function and quality of life.

Prognosis

The prognosis for individuals with PTLD varies. While some patients may experience stable lung function, others may have progressive decline. Early detection and management are crucial to improving outcomes.

Prevention

Preventing post-tuberculosis lung disease involves effective treatment of the initial TB infection and regular follow-up to monitor lung health. Vaccination with the BCG vaccine can help prevent TB infection, thereby reducing the risk of developing PTLD.

Related pages

• Tuberculosis
• Pulmonary fibrosis
• Bronchiectasis
• Aspergillosis