Tuberculosis: A Clinical Practice Guide

Tuberculosis: A Natural History of the Disease

Author(s): Rafael Laniado-Laborín

Pp: 12-16 (5)

DOI: 10.2174/9789811488511120010006

* (Excluding Mailing and Handling)

Abstract

Tuberculosis infection occurs when a subject inhales the Mycobacterium tuberculosis bacilli (MTB). An active case of pulmonary or laryngeal tuberculosis generates infectious particles called droplet nuclei of <5 microns in diameter, when coughing, sneezing or through any other forceful expiratory maneuver. The infectiousness of a patient with TB is directly related to the form of the disease (laryngeal, pulmonary), the presence of cough, cavitary lung disease and the positivity of the sputum smear/culture.

The prevalence of M. tuberculosis infection among household contacts is higher than 50%. Contacts who are <5 years of age or HIV infected have the most significant risk of developing tuberculosis once they acquire the infection.

In latent tuberculous infection, most bacilli are metabolically inactive, and only a few are replicating. In immunocompetent individuals, these bacilli are destroyed by the immune defenses of the host and the development of active disease aborts. When the immunity of the subject fails, the bacilli multiply, and eventually, active tuberculosis ensues. If latent infection tuberculosis is not treated, approximately 5% of infected individuals will develop the active disease within the first two years after infection, and another 5% will develop TB sometime later in life.

HIV infection is the most significant risk factor for the progression of LTBI to active TB disease, with an annual risk of 7-10% for subjects who are not receiving highly active antiretroviral treatment.


Keywords: Cavitary disease, Cough, Droplet nuclei, Immunity, Latent tuberculosis infection, T lymphocytes.Cavitary disease, Cough, Droplet nuclei, Immunity, Latent tuberculosis infection, T lymphocytes.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314508452 and j.to_ip >=314508452 )) and ((j.from_date <= 1740549483 and j.to_date >= 1740549483 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14365) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314508452 and j.to_ip >=314508452 )) and ((j.from_date <= 1740549483 and j.to_date >= 1740549483 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14365) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 314508452 and j.to_ip >=314508452 )) and ((j.from_date <= 1740549483 and j.to_date >= 1740549483 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 14365)
      980μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2923 and `b`.`banner_from_date` <= 1740549483 and `b`.`banner_to_date` >= 1740549483 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      11.95msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2923
      • 3: 1740549483
      • 4: 1740549483
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='1892dd972bd7cb6573d29020916079e3'
      330μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    11Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        52DmPqF1fHb7XViiPQKaSWuSxxgfKM3rwD0nOHzP
        uc_cart_id
        1892dd972bd7cb6573d29020916079e3
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14365" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/14365
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:16 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        []
        
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Wed, 26 Feb 2025 05:58:03 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IndDck5sbEJTOXY3ZnlhNHEwcW9OdVE9PSIsInZhbHVlIjoiOHorQUcvVDU4YUpqYjVKQVVoM0RKN3F5dzR0dkJReEZZZmo3YW4vTmRseTBzWU9UVTZEYVUyQXJ0TjBRamt4bFY0Z0JJb2F4cExqbk9FTFcxTUsyRytzUG9MNktPNk11Yjdqai9XTkNlZmhRZVB3bC9RcWc5MTJ6a3d0ZG5tZlIiLCJtYWMiOiJlYjlmZjU3ZmIyNzczYzllNTU2NzA1MjViYmRkMzljYWEwMzY4Y2ZmZTAzMGYxNjNhZGJmZTM2MmY3MjE0MzUwIiwidGFnIjoiIn0%3D; expires=Fri, 28 Feb 2025 17:58:03 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IndDck5sbEJTOXY3ZnlhNHEwcW9OdVE9PSIsInZhbHVlIjoiOHorQUcvVDU4YUpqYjVKQVVoM0RKN3F5dzR0dkJReEZZZmo3YW4vTmRseTBzWU9UVTZEYVUyQXJ0TjBRamt4bFY0Z0JJb" 1 => "alphaeurekaselectnet_session=eyJpdiI6Ik9ieUJaamhLdGFqUml3bjFmUWkxdkE9PSIsInZhbHVlIjoiRlFyTVF4Qmg0elIyZ2FwZWJ0OUhkMDBabUJTbWkveWlsUnRva2dEZzFDVE83VjJFS1RCaGI0aDUxN1o3RHpyU3U3WnBCMmhoMzYzWDhjNkZoYjIrMldqSitYR0E2YVl5K1lQNmVrOFYya091azZkbGJxc25SKzdQUkoxTWpZUXUiLCJtYWMiOiIyZGNhYzgzNDZhY2I0OWIyODFmZjkzNzg0OGZhMWQyMWNjMTFmOGJiMGNmZjhlNzNjZTg1MDgxZWRiOTA3NWYxIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6Ik9ieUJaamhLdGFqUml3bjFmUWkxdkE9PSIsInZhbHVlIjoiRlFyTVF4Qmg0elIyZ2FwZWJ0OUhkMDBabUJTbWkveWlsUnRva2dEZzFDVE83VjJFS1RCaGI0aDU" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IndDck5sbEJTOXY3ZnlhNHEwcW9OdVE9PSIsInZhbHVlIjoiOHorQUcvVDU4YUpqYjVKQVVoM0RKN3F5dzR0dkJReEZZZmo3YW4vTmRseTBzWU9UVTZEYVUyQXJ0TjBRamt4bFY0Z0JJb2F4cExqbk9FTFcxTUsyRytzUG9MNktPNk11Yjdqai9XTkNlZmhRZVB3bC9RcWc5MTJ6a3d0ZG5tZlIiLCJtYWMiOiJlYjlmZjU3ZmIyNzczYzllNTU2NzA1MjViYmRkMzljYWEwMzY4Y2ZmZTAzMGYxNjNhZGJmZTM2MmY3MjE0MzUwIiwidGFnIjoiIn0%3D; expires=Fri, 28-Feb-2025 17:58:03 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IndDck5sbEJTOXY3ZnlhNHEwcW9OdVE9PSIsInZhbHVlIjoiOHorQUcvVDU4YUpqYjVKQVVoM0RKN3F5dzR0dkJReEZZZmo3YW4vTmRseTBzWU9UVTZEYVUyQXJ0TjBRamt4bFY0Z0JJb" 1 => "alphaeurekaselectnet_session=eyJpdiI6Ik9ieUJaamhLdGFqUml3bjFmUWkxdkE9PSIsInZhbHVlIjoiRlFyTVF4Qmg0elIyZ2FwZWJ0OUhkMDBabUJTbWkveWlsUnRva2dEZzFDVE83VjJFS1RCaGI0aDUxN1o3RHpyU3U3WnBCMmhoMzYzWDhjNkZoYjIrMldqSitYR0E2YVl5K1lQNmVrOFYya091azZkbGJxc25SKzdQUkoxTWpZUXUiLCJtYWMiOiIyZGNhYzgzNDZhY2I0OWIyODFmZjkzNzg0OGZhMWQyMWNjMTFmOGJiMGNmZjhlNzNjZTg1MDgxZWRiOTA3NWYxIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6Ik9ieUJaamhLdGFqUml3bjFmUWkxdkE9PSIsInZhbHVlIjoiRlFyTVF4Qmg0elIyZ2FwZWJ0OUhkMDBabUJTbWkveWlsUnRva2dEZzFDVE83VjJFS1RCaGI0aDU" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "52DmPqF1fHb7XViiPQKaSWuSxxgfKM3rwD0nOHzP" "uc_cart_id" => "1892dd972bd7cb6573d29020916079e3" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/14365" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-26 05:58:03GET/chapter/143651121913