Cavitary Pulmonary Tuberculosis

In cavitary pulmonary tuberculosis, long-standing cavities gradually thicken; depending on treatment efficacy and immunity, lesions alternate between resolution and deterioration, forming chronic fibro-cavitary TB with a protracted course, fluctuating symptoms, and positive sputum, making it the main source of TB transmission. X-rays show unilateral or bilateral, single or multiple thick-walled cavities, often with bronchogenic spread lesions and pleural thickening. Fibrotic contraction elevates the hilum with weeping willow markings, the mediastinum shifts to the affected side, and adjacent or contralateral lung shows compensatory emphysema, often complicated by chronic bronchitis, bronchiectasis, secondary lung infection, and cor pulmonale. Severe cases show widespread lung destruction and fibrosis leading to lobar or unilateral lung contraction, forming a destroyed lung.

Common Symptoms

Middle lobe fibrosis; moist rales; hemoptysis; signs of sepsis; cough; night sweats; low fever; weight loss

Causes and Pathogenesis

Tubercle bacilli are pathogenic acid-fast bacilli of the genus Mycobacterium, mainly human, bovine, avian, and murine types; the human type is mainly pathogenic. Drug resistance arises from naturally resistant strains or acquired resistance from single-drug therapy.

Treatment

Drug therapy, supportive therapy

Preventive Measures

1. BCG vaccination for uninfected individuals. 2. Chemoprophylaxis for selected infected individuals including close contacts, Mantoux converters, and non-active TB with immunosuppression, radiotherapy, peri-gastrectomy, strongly positive reactions, dual TB-HIV, renal transplant, diabetes, or silicosis. Isoniazid: adults 0.3 g/day, children 6-8 mg/(kg·day), for 6 months. 3. Eliminate the source of infection: smear-positive pulmonary TB is the main source; new and retreatment smear-positive cases are the main chemotherapy targets.

Department to Visit

It is recommended to visit the Respiratory department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.