Clinical classification of pulmonary tuberculosis

The tuberculosis we often talk about in our daily lives actually has many classifications, and tuberculosis is just a general name. There are many clinical types of pulmonary tuberculosis, such as primary pulmonary tuberculosis, blood type disseminated pulmonary tuberculosis, infiltrative pulmonary tuberculosis, and chronic fibrocavitary pulmonary tuberculosis. These four types are the clinical types of pulmonary tuberculosis. If symptoms of some types of diseases appear, routine examinations should be carried out in a timely manner.

Primary pulmonary tuberculosis: It is more common in children, but can also be seen in adults who have just moved to the city from remote areas and new soldiers. Symptoms are mostly mild and similar to a cold, and may include slight fever, loss of appetite, cough, weight loss, etc. There are usually no abnormal signs in the chest. X-ray examination shows that the primary lesions in the lungs are connected to the enlarged hilar lymph nodes or paratracheal lymph nodes by cord-like shadows, which is called the primary syndrome. If the primary lesion in the lung is not obvious and the main symptom is lymph node enlargement, it is called intrathoracic lymph node tuberculosis. Primary pulmonary tuberculosis can often be absorbed or calcified on its own. Sometimes enlarged lymph nodes compress the bronchi and cause atelectasis.

Hematogenously disseminated pulmonary tuberculosis: Acute hematogenously disseminated pulmonary tuberculosis (miliary tuberculosis) is caused by a large number of bacteria entering the bloodstream in a short period of time. The onset is rapid, and the symptoms of systemic poisoning are severe, often with high fever, which can reach above 39°C. The pulse is often relatively slow. There may be moist rales in the chest, and X-ray examination reveals miliary shadows in the lungs, evenly distributed on both sides. Subacute or chronic hematogenously disseminated pulmonary tuberculosis is caused by a small number of tuberculosis bacteria entering the lungs through the bloodstream in batches, resulting in disseminated lesions. The lesions are often of varying sizes and ages, and are mostly distributed in the upper and middle parts of both lungs.

Infiltrative pulmonary tuberculosis: The most common type of pulmonary tuberculosis in adults. It is caused by endogenous reinfection, and the clinical symptoms vary depending on the nature and extent of the lesions, the presence or absence of cavities and the body's reactivity. There may be no symptoms, or there may be non-specific chronic respiratory infection symptoms, such as afternoon fever, night sweats, weight loss, cough, chest pain, hemoptysis, etc. X-ray examination showed infiltration shadows in the lungs, mostly in the apical and posterior segments of the upper lobes. After anti-tuberculosis treatment, the lesions may disappear, fibrose or calcify. Cavities may form due to caseous necrosis and liquefaction. And can form spherical lesions (tuberculoma).

Chronic fibrocavitary tuberculosis: Tuberculosis cavities do not heal for a long time and develop into thick-walled cavities and extensive pulmonary fibrosis, often accompanied by repeated bronchial dissemination and obvious pleural hypertrophy. The clinical manifestations alternate between improvement and deterioration, with repeated hemoptysis, which often leads to lung function damage and cor pulmonale.