disease. More than 1^1 / 2 billion people in the world may have TB and many do
not know it. Each year there are more than 8 million new bases of TB. Many
of the new cases of TB can be attributed, in part, to the increased number of
persons with acquired immunodeficiency syndrome (AIDS). Active TB devel-
ops in these people because of their compromised immune system. It can also
be attributed to the increasingly crowded living conditions in urban areas.
Individuals susceptible to TB are those with alcohol addiction, AIDS, and those
in a debilitative condition.
Tuberculosis is transmitted from one person to another by droplets dispersed
in the air through coughing and sneezing. The organisms are inhaled into the
alveoli (air sacs) of the lung. The tubercle bacilli can spread from the lungs to
other organs of the body via the blood and lymphatic system. If the body’s
immune system is strong or intact, the phagocytes stop the multiplication of the
tubercle bacilli. When the immune system is compromised, the tubercle bacilli
spread in the lungs and to other organs. Dissemination of tuberculosis bacilli can
be found in the liver, kidneys, spleen, and other organs. Symptoms of TB include
anorexia, cough, sputum production, increased fever, night sweats, weight loss,
and positive acid-fast bacilli (AFB) in the sputum. Medication to treat and pre-
vent TB is discussed in Chapter 13.CHRONIC BRONCHITIS
Chronic bronchitis is an inflammation of the bronchi that persists for a long
period of time or repeatedly occurs. It is a form of COPD. Smoking is the main
cause for bronchitis. Second-hand smoke may also cause chronic bronchitis. Air
pollution, infection, and allergies make it worse. Patients who develop chronic
bronchitis have excess mucous production that irritates the bronchial causing the
patient to have a persistent productive cough.
Patients exhibit a gurgling lung sound (rhonchi) both on inspiration and expi-
ration. The excess mucus blocks the airway causing a build up of carbon diox-
ide in the blood (hypercapnia) and a decrease in oxygen (hypoxemia) which
leads to respiratory acidosis.BRONCHIECTASIS
Brochiecstasis is the enlargement and distension of the airways so that pockets
are formed where infection can develop. This condition alters the lining of the
airways and damages the lung’s ability to filter air. Dust, mucus, and bacteria
accumulate in the lungs, causing infection.(^262) CHAPTER 14 Respiratory Diseases