Ortona L, Federico G
Istituto di Clinica delle Malattie Infettive, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy.
Rays. 1998 Jan-Mar;23(1):64-77.
Pulmonary tuberculosis: primary tuberculosis, usually asymptomatic, represents the first infection and is shown by a parenchymal mostly mid-pulmonary focus and satellite lymphadenopathy. Postprimary pulmonary tuberculosis, mostly located in the upper fields may be caused by endogenous reinfection for reactivation of a hematogenous focus formed during primary infection or from exogenous reinfection. Extrapulmonary tuberculosis: it includes numerous forms mostly from hematogenous spread. Miliary tuberculosis may involve a number of organs and apparatus besides the lung. Tuberculous meningitis predominantly involves the base of the skull, the fluid is clear with hypoglycorrhachia and lymphocyte pleocytosis. Lymph node tuberculosis is generally unilateral and cervical. Tuberculous pleuritis is exudative or dry. Other forms of tuberculous serositis are pericarditis and peritonitis. Renal tuberculosis involves the medullaris and intestinal tuberculosis the ileocecum; tuberculous spondilitis (Pott's disease) involves the last dorsal vertebrae. Other forms are osteoarthritis, genital tract tuberculosis, pancreatitis, laryngitis, otitis.
原发性肺结核通常无症状,是首次感染,表现为肺实质内主要位于肺中部的病灶及卫星淋巴结病变。继发性肺结核大多位于肺上部,可能由原发性感染期间形成的血行播散病灶的内源性再激活或外源性再感染引起。肺外结核:包括多种主要由血行播散引起的类型。粟粒性结核除累及肺脏外,还可累及多个器官和组织。结核性脑膜炎主要累及颅底,脑脊液清晰,糖含量降低,淋巴细胞增多。淋巴结结核一般为单侧,多位于颈部。结核性胸膜炎可为渗出性或干性。其他类型的结核性浆膜炎包括心包炎和腹膜炎。肾结核累及髓质,肠结核累及回盲部;结核性脊柱炎(波特病)累及最后几个胸椎。其他类型包括骨关节炎、生殖道结核、胰腺炎、喉炎、中耳炎。