IM CC BUENAFE

IM CC BUGNA
PGI EVANGELISTA
 Lowenstein Jensen Medium
(LJ Medium)
• LJ Medium Base :
L-Asparagine = 3.6 g
Monopotassium Phosphate = 2.5 g
Magnesium Sulfate = 0.24 g
Sodium Citrate = 0.6 g
Malachite Green = 0.4 g
Potato Flour = 30 g
• Supplements:
Glycerol = 12 ml
Egg suspension = 1000 ml
 Latent tuberculosis infection (LTBI)
• Several weeks after infection, two host responses to M.
tuberculosis develop: a macrophage-activating CMI response
and a tissue-damaging response.
• The macrophage-activating response is a T cell–mediated
phenomenon resulting in the activation of macrophages that
are capable of killing and digesting tubercle bacilli.
• The tissue-damaging response is the result of a delayed-type
hypersensitivity (DTH) reaction to various bacillary antigens; it
destroys unactivated macrophages that contain multiplying
bacilli but also causes caseous necrosis of the involved tissues.
• Although both of these responses can inhibit mycobacterial
growth, it is the balance between the two that determines the
forms of TB that will develop subsequently.
Source: Harrison’s Principle of Medicine 19th Edition
• With the development of specific immunity
and the accumulation of large numbers of
activated macrophages at the site of the
primary lesion, granulomatous lesions
(tubercles) are formed.
• Initially, the tissue-damaging response can
limit mycobacterial growth within
macrophages.

Source: Harrison’s Principle of Medicine 19th Edition

• Mediated response by various bacterial
products, not only destroys macrophages but
also produces early solid necrosis in the center
of the tubercle.
• Although M.tuberculosis can survive, its
growth is inhibited within this necrotic
environment by low oxygen tension and low
pH.

Source: Harrison’s Principle of Medicine 19th Edition

• Some lesions may heal by fibrosis, with
subsequent calcification, whereas
inflammation and necrosis occur in other
lesions.
• Disabled mutations in mycobacterial genomes
rendering their replication ineffective.
• Individual granuloma are formed with varying
size and cell composition, some may contain
and spread the bacteria, some cannot .
Source: Harrison’s Principle of Medicine 19th Edition
Latent tuberculosis infection (LTBI)
• Latent tuberculosis infection (LTBI) is a state of
persistent immune response to stimulation by
Mycobacterium tuberculosis antigens without
evidence of clinically manifested active TB.
Someone has latent TB if they are infected
with the TB bacteria but do not have signs of
active TB disease and do not feel ill. However,
they can develop active TB disease in the
future.
Source: World Health Organization
 DIAGNOSIS OF LATENT M.
TUBERCULOSIS INFECTION

• Tuberculin Skin Testing

Source: Harrison’s Principle of Medicine 19th Edition