Pulmonary Tuberculosis

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Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis, The disease is so called because of the formation of tubercles in the affected part of the body. Tuberculosis can affect any organ or tissue of the body, but its more predominant form is pulmonary tuberculosis. There is not much awareness of the disease among the general public. Social toboos also prevent notification and reporting. Written lucidly, the book looks at the disease intgeneral its causes, diagnosis and treatment. The book will be of interest to those who are involved in the detection and control of tuberculosis as well as to educate patients whose understanding and co-operation are essential for the success of the Tuberculosis Control Programme. It will also meet the needs of the medical students, physicians in tuberculosis hospitals, general practitioners as well as medical and non-medical personnel

M.P.S. Menon taught internal medicine, chest diseases, tuberculosis, allergy and immunology at the Vallabhbhai Patel Chest Institute, University of Delhi. His research Farticles have been published in medical journals in the UK, USA, Europe and India. Among his books including Radiology Clinics in Chest Diseases and Asthma: How to Control it, both of which have been published by the National Book Trust, India.

The first edition of this book which appeared in 1983 and the second edition of 1985 were well received and all the copies were sold out, necessitating a reprint. As major advances have occurred in the field of tuberculosis since the last edition, it became necessary to bring out an updated edition.

The chapter on host-parasite interaction is revised, adding new information on the immunology of tuberculosis. A new chapter has been added to cover drug-resistant tuberculosis and AIDS. The revised National Tuberculosis Control Programme has been explained in detail. Advances in diagnostic methods have been covered and a new section on chemoprophylaxis added. Major revisions have been carried out in the chapter on treatment of tuberculosis, incorporating the current recommendations of WHO.

Despite the author's effort to present as much new material as possible in this edition, the amount of information that is coming to the fore exceeds the author's ability to keep within the confines of one volume. The author is indebted to Dr Balakrishnan Menon, who helped in revising and correcting the entire text of this book, the National Book Trust, India and Ms Manju Gupta in particular, for the keen interest shown in bringing out this edition.

Tuberculosis is an infectious disease caused by the bacillus Mycobacterium tuberculosis. The disease is so called because of the formation of tubercles in the affected parts of the body. The name 'mycobacterium' was proposed by Lehmann and Neumann in 1896 to describe a genus of bacteria which produce mould like (fungus-like) pellicles when grown in liquid culture media. They are, however, not related to the fungi (moulds). There are about 30 well- defined species under this genus, mycobacterium. Two of the dreaded diseases of man, namely, tuberculosis and leprosy, are caused by two species of mycobacterium (My- cobacterium tuberculosis and Mycobacterium leprae). In addition, there are a number of specific and non-specific infections caused by other species of mycobacteria which normally exist in the environment as saprophytes. Although infections due to such species are rare (compared to tuberculosis and leprosy), they may occasionally cause serious diseases such as pulmonary tuberculosis, buruli ulcer, swimming pool granuloma, etc. Mycobacterial infection leads to formation of tubercles in the affected parts. These tubercles are formed by the accumulation of cells (defence cells) of the host around the bacilli in an attempt to destroy or contain these bacilli. Tubercles as a rule lead to abscess formation, the pus having the appearance and consistency of cheese (hence, the term 'caseation'). The caseous mass may be surrounded by fibrous tissue and calcify slowly.