Tuberculose pulmonar em adultos: manifestações clínicas e complicações

Abstract

Introduction: Pulmonary tuberculosis is an infectious and transmissible disease that affects the lungs and is caused by the bacterium Mycobacterium tuberculosis, also known as Koch's bacillus. Objective: to discuss pulmonary tuberculosis in adults: clinical manifestations and complications. Methodology: Literature review from Scielo, PubMed and BVS databases, from January to April 2024, with descriptors “Pulmonary tuberculosis”, “Clinical manifestations” and “Complications”. Articles from 2019-2024 (total 147) were included, excluding other criteria and choosing 05 full articles. Results and Discussion: Clinical manifestations of pulmonary tuberculosis (TB) include primary TB, reactivation and reactivation TB, endobronchial TB, lower lung field TB, tuberculoma and laryngeal TB. Among patients with primary TB, clinical manifestations were observed in approximately one third of cases. Symptoms include fever and chest pain. Retrosternal pain and dull interscapular pain have been attributed to enlarged bronchial lymph nodes. Reactivation TB refers to the reactivation of a previously dormant focus seeded at the time of primary infection. The apical and posterior segments of the upper lobes are the most frequently involved sites. Symptoms are typically insidious and may include cough, weight loss, fatigue, fever, night sweats, chest pain, dyspnea, and/or hemoptysis; these findings are seen less frequently in patients >60 years. Endobronchial TB may develop through direct extension into the bronchi from an adjacent parenchymal focus (usually a cavity) or through dissemination of organisms into the bronchi via infected sputum. It may occur in patients with primary TB or reactivation TB and was seen most frequently before the era of antituberculous therapy. Conclusion: Pulmonary complications of TB include hemoptysis, pneumothorax, bronchiectasis, extensive lung destruction (including pulmonary gangrene), acute respiratory distress syndrome, septic shock, malignancy, venous thromboembolism, and chronic pulmonary aspergillosis.