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Pathophysiology of Koch’s Disease


Predisposing Factors: Precipitating Factors:

• Age - Occupation (e.g Health Workers)

• Immunosuppression - Repeated close contact w/ infected


o Prolonged corticosteroid therapy - Indefinite substance abuse via IV

• Systemic Infection: - recurrence of infection

o Diabetes Mellitus

o End-stage Renal Disease

o HIV or AIDS infection

Exposure or inhalation of infected

Aerosol through droplet nuclei

(exposure to infected clients by coughing,

sneezing, talking)

Tubercle bacilli invasion in the apices of the

Lungs or near the pleurae of the lower lobes

Bronchopneumonia develops in the lung tissue

(Phagocytosed tubercle bacilli are ingested by macrophages)

 bacterial cell wall binds with macrophages

 arrest of a phagosome which results to bacilli replication

Necrotic Degeneration occurs

(production of cavities filled with cheese-like

mass of tubercle bacilli, dead WBCs, necrotic lung tissue)

drainage of necrotic materials into the

tracheobronchial tree

(eruption of coughing, formation of lesions)

Lesions may calcify (Ghon’s Complex)

and form scars and may heal

over a period of time

Tubercle bacilli immunity develops

(2 to 6 weeks after infection)

(maintains in the body as long as living

bacilli remains in the body)

Acquired immunity leads to further growth

Of bacilli and development of ACTIVE INFECTION


Pulmonary Symptoms: General Symptoms:

• Dyspnea - Fatigue

• Non-productive or productive cough - anorexia

• Hemoptysis (blood tinge sputum) - Weight loss

• Chest pain that may be pleuritic or dull - low grade fever with
chills and

• Chest tightness sweats (often at night)

• Crackles may be present on auscultation

With Medical Intervention Without Medical intervention

• Early detection/ diagnosis of the dse Reactivation of the tubercle bacilli

• Multi-antibacterial therapy (Due to repeated exposure to infected

• Fixed- dose therapy Individuals, Immunosuppression)

• TB DOTS (Direct Observed Therapy) SECONDARY INFECTION

• BCG vaccination

Severe occurrence of lesions in the lungs

No Recurrence Recurrence

Cavitation in the lungs occurs

Good Prognosis Bad Prognosis

Active infection is spread throughout

the body systems

(infiltration of tubercle bacilli in other organs)

 TB of the Bones

 Pott’s Disease

 Renal TB


Client becomes clinically ill