OVERVIEW
Overview.
Primary tuberculous relapse of the lungs is also called primary syndrome. In primary tuberculosis, the primary lesions in the lungs, lymphadenitis, and tuberculosis of the hilar lymph nodes are called primary syndrome, and the X-ray shows a dumbbell-shaped shadow, and the clinical signs and symptoms are mostly unremarkable.
Whether medical insurance
yes
Department
Tuberculosis, Respiratory Medicine, Infection
Alias
Pulmonary Primary Syndrome
Clinical Symptoms
Fever, cough, shortness of breath, fatigue, night sweats and emaciation are the main clinical symptoms.
Hazards
A high percentage of lymphocytes and mild anemia may be present. A few patients may have a leukemia-like reaction. There may also be a decrease in whole blood cells, suggesting bone marrow suppression. In women, menstrual disorders and amenorrhea may occur.
Complications
Pneumothorax, bronchiectasis, etc.
Examination
CT, sputum antacid staining, culture of Mycobacterium tuberculosis, PCR, tuberculin skin test, in vitro interferon-gamma test, bronchoscopy, biopsy.
Diagnosis
The patient has clinical manifestations such as fever, night sweats, fatigue, weight loss, cough, abnormal breath sounds on lung auscultation, dumbbell-shaped shadow on chest X-ray, positive sputum antacid staining, sputum Mycobacterium tuberculosis culture of Mycobacterium tuberculosis, positive PCR of Mycobacterium tuberculosis, and confirmation of tuberculosis lesions by biopsy histopathologic examination.
Treatment principle
Appropriate rest, reduce physical activity, pay attention to nutrition. Symptomatic treatment such as stopping cough and expectorant. Anti-tuberculosis medication should be used early, in combination, in the right amount, regularly and in the whole course.
Curability
Generally curable, some drug-resistant tuberculosis infection has poor prognosis.
Dietary advice
1. The diet should be fluid or semi-fluid and easily digestible food, each meal should be warm and cool and should not be too much, and attention should be paid to keep the bowel movement unimpeded. 2. Adequate protein and iron should be supplied. Eat more lean meat, animal liver, tofu, soy milk, etc. 3. Eat more food containing vitamin A, C and calcium.
Important Reminder
For disease prevention, uninfected persons such as newborns, enlisted recruits and new trainees with negative tuberculin test, adolescent workers newly arrived at tuberculosis medical units, and adolescents undergoing renal transplantation should be immunized with BCG vaccine. Sputum smear-positive tuberculosis is the main source of infection, and eliminating the source of infection is the fundamental countermeasure to control tuberculosis. Primary smear-positive TB and retreatment smear-positive TB are the main targets of chemotherapy. Cough suppressants and sedatives should be used cautiously, and patients should be instructed to cough effectively to ensure a clear airway.
Etiology
Epidemiology
Most often occurs in children or young people, especially infants and young children under 3 years old.
Etiology
The disease is caused by inhaling dust or droplets containing tubercle bacilli from the air.
Transmission
Respiratory
Symptoms and Diagnosis
Typical symptoms
Fever, cough, shortness of breath, fatigue, night sweats, emaciation. Chest signs may vary greatly depending on the extent and degree of lung disease and the presence or absence of complications.
Diagnostic basis
The patient has clinical manifestations such as fever, night sweats, fatigue, weight loss, cough, abnormal breath sounds on lung auscultation, dumbbell-shaped shadows on chest imaging, positive sputum antacid staining, sputum Mycobacterium tuberculosis culture of Mycobacterium tuberculosis, positive PCR Mycobacterium tuberculosis, and confirmation of tuberculosis lesions by biopsy histopathologic examination.
Treatment
Treatment guidelines
Appropriate rest, reduce physical activity, pay attention to nutrition. Anti-tuberculosis drug treatment.
Drug treatment
Anti-tuberculosis drug treatment, i.e. basic treatment or chemotherapy. (1) Principles of chemotherapy: early, combined, appropriate amount, regularity, whole course. (2) Chemotherapy methods: tonic therapy, intermittent therapy, ambulatory therapy, short course therapy, ultra-short course therapy, supervised (supervised) therapy (DOT or DOTS). (3) Commonly used drugs: isoniazid and rifampicin are fully bactericidal, streptomycin and pyrazinamide are semi-bactericidal. Commonly used bacteriostatic drugs such as sodium paracetamol, ethambutol, kanamycin, colistin, propylthioisonicotinamide, aminothiourea. Commonly used new drugs such as rifapentine, butamidokanamycin, forceps lung disease, flucloxacin, ciprofloxacin. Combination drugs such as Weilunate and Weilunin.
Other treatments
Appropriate rest, reduce physical activity, pay attention to nutrition.
Prognosis
Generally can be cured, some drug-resistant tuberculosis infection treatment effect is poor, poor prognosis, combined with serious complications can be life-threatening.
Nursing care
Daily care
1、Use cough suppressants and sedatives with caution, instruct patients to cough effectively and ensure the airway is clear.2、Diet should be fluid or semi-liquid easy-to-digest food, and each meal should be warm and cool and should not be too much, and pay attention to keep the bowel movement clear.
Dietary management
1. Supply sufficient protein and iron. Eat more lean meat, animal liver, tofu, soy milk, etc. 2. Eat more food containing vitamin A, C and calcium.