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Cavitary lesion CXR
Cavitary lesion CT

Infection caused by Mycobacterium tuberculosis

Primary TB

  • Initially presents as a homogeneous opacity without lobe predominancy and hilar lymphadenopathy in young
  • Results in Ghon complex which may or may not calcify and prominent hilar lymph nodes (Ranke)
  • 95% clinically silent

Post Primary TB

  • Reactivation
  • Pneumonia of the apical or posterior segments of the upper lobes
  • May cause cavitation
  • Lymphadenopathy uncommon
  • Often asked to assess stability which is difficult without comparison (6 months)

Milliary TB: <3mm diffuse nodules, results from hematogenous spread.

Rasmussen's Aneurysm: mycetoma in a TB cavity erodes an artery causing massive hemoptysis

HIV Related

  • If CD4 count >200 acts like others
  • If CD4 count <200 get Milliary TB, LAD without airspace disease
  • Can appear to worsen on HAART, due to body's response