This case study considers a 63-year old Asian male diagnosed with pulmonary tuberculosis due to drug-sensitive Mycobacterium tuberculosis.
The patient is in the high risk group as his age, gender and ethnicity are risk factors for tuberculosis. The immune system of the elderly is often compromised (National Health Service, 2012). The patient’s age suggests a weak immune system, increasing his susceptibility to M.tuberculosis.
Individuals originating from countries where tuberculosis is prevalent are at a higher risk of developing active tuberculosis (National Health Service, 2012). Tuberculosis is still highly prevalent in Asia as The World Health Organisation (2012), states “Of the estimated 9 million people…show more content… This trend was not reflected with gender as, according to the same Public Health England (2014) report over half of the tuberculosis cases in 2013 were male. Figure 2, taken from a report by the World Health Organisation (2014), shows that estimated tuberculosis incidence in South-East Asia has remained very high from 1990-2013. Baring Africa, South-East Asia has the highest incidence rate from 1990-2013, however the Western pacific has shown a significant decrease in its incidence rate, showing that tuberculosis is still highly prevalent in certain parts of Asia.
As stated by Greenwood et al., (2002), the lung is often the location of initial infection. The tubercle bacilli, consumed by macrophages in the alveolar, replicate forming the initial lesion called the Ghon focus. The resulting primary complex formed includes the Ghon focus and enlarged hilar lymph nodes. The nodes contain further Ghon foci which develop due to bacilli being transported by phagocytic cells. Additionally, bacilli are propagated to many organs, tissues and other parts of the lung by the blood and lymph system.
However, not all bacillus are destroyed during the immune response. Some survive within the macrophage, remaining dormant and can later cause a post-primary disease. In most cases, the primary complex is destroyed, nonetheless, on rare occurrences a contagious foci develops and causes the