Textbook of Tuberculosis and Nontuberculous Mycobacterial Diseases Surendra K Sharma, Alladi Mohan
INDEX
Page numbers followed by f refer to figure and t refer to table.
A
Abacavir 474, 475
Abdomen
doughy feel of 357
ultrasonography of 215
Abdominal distension 209, 215
Abdominal lymph nodes, tuberculosis of 208
Abdominal pain 215, 394, 638
acute 456
Abdominal tuberculosis 40, 129, 208221, 496, 498f, 505
classification of 208t
complications 41
diagnostic criteria for 213
differential diagnosis 41
role of surgery 496
treatment 217
Abdominal vague 357
Abdominal wall, discharging sinus in 554f
Abortion 326, 365
Abscess 142
Bartholin 357
Brodie's 292
collar-stud 314
complete resolution of 363f
drainage 522
fungal 247, 247t
intra-abdominal 210
metastatic 392
para-articular cold 294
paravertebral 139f, 175, 271f, 271
perinephric 496
prevertebral 139f, 326, 328f
psoas 139, 401f
pus from cold 403
pyogenic 132, 247, 247t
retropharyngeal 327
scrotal 370
subcutaneous 309
type of 247
Acetabulum and granulation tissues, destruction of 276f
Acid-fast bacilli 27, 29, 109, 112, 156, 162, 177f, 186, 303, 308f, 488, 490, 524, 551, 586, 627
smear preparation 764
Acidic environment 216
Acquired immunodeficiency syndrome 10, 25, 30, 92, 113, 175, 208, 222, 226, 227, 227t, 231, 313, 326, 335, 368, 448, 468, 473, 533, 545, 609, 681, 685, 690, 692, 697, 712, 713
clinical trials group 473
related deaths 468
Acromioclavicular joint, tuberculosis of 290
Actinomyces 240
Actinomycetales 52
Actinomycetes 240
Actinomycosis 131, 152, 165, 357
Acute respiratory distress syndrome 125, 126, 323, 432436, 437f, 439
diagnosis of 432, 432t, 438
epidemiology 435
management 440
pathogenesis 432
predisposing factors 435
prognosis 440
tuberculosis and 432441
Addison's disease 77, 455
Addisonian crisis 456
Additive toxicities 475t
Adenocarcinoma 496
Adenosine
deaminase 109, 179, 180, 186, 215, 513
monophosphate, cyclic 736
triphosphate 597
Adhesiolysis 499
Adrenal glands, tuberculosis of 135
Adrenocorticotrophic hormone 456
Adverse drug reaction 472, 513, 626t
Advocacy communication and social mobilisation 722
Aerosol infection 95
AFB See Acid-fast bacilli
Ageing and immunosenescence 509
AIDS See Acquired immunodeficiency syndrome
Air
cleaners, in-room 525
crescent’ sign 126f
filtration and disinfection 525
Airborne
infections, control 762
transmission
of tuberculosis, reducing 763, 763t
strategies for reducing 761, 763
tuberculosis transmission 759, 760
and infection control strategies 759767
Air-bronchogram 437f
Air-fluid levels 122
Airway
complications 126
in autopsy 160
involvement 114, 123
malacia 167
obstruction, major 500, 501
stenosis 165
stents 168
trauma 168
Alanine amino transferase 638
Albumin 599
Alcohol 639
Alimentary tract 32
All India Organisation of Chemists and Druggists 681
Allergic bronchopulmonary aspergillosis 123, 152
Alveolar epithelial cell 433
Alveolar macrophages 61f
Ambulatory gastric lavage 486
Amenorrhoea 148
American Thoracic Society 638
Amikacin 386, 560, 562, 618, 623
Amino acid 74, 81
Amino salicylic acid 458
Aminoglycosides 384, 610, 627
Amniotic fluid 31
Amyloidosis 163, 428
secondary 419, 496
Anaemia 148, 209, 395, 442, 443, 448, 630
drug-induced 443
in tuberculosis, aetiological factors for 443t
Anal canal 214
Aneurysmal phenomenon 271
Angiopoietin-2 433
Angiotensin converting enzyme 185
Ankle and foot, tuberculosis of 282
clinical features 282
management 283
pathology 282
radiographic features 282
Ankle joint 298f
contrast-enhanced MRI of 298f
Ankylosed wrist 289f
Ankylosing spondylitis 77
Anorectal tuberculosis 131
Anorexia 280, 394, 510f
Ansamycins 561
Anthracofibrosis 151, 165
Anti-aspergillus IgG antibodies 152
Antibiotics, inhaled 582
Antidiabetic drugs 460
Antidiuretic hormone 512
Antigen detection 235
Anti-hypertensive drug prescription 385
Antimicrobial resistance, surveillance of 610
Antimycobacterial antibodies 235
Antimycobacterial effector functions, free radical-based 61
Anti-retroviral drugs 19, 405, 476
classification of 472t
side effects of 475t
Anti-retroviral therapy 468, 472, 474
goals of 472t
highly active 473
Anti-retroviral treatment 632
provision of 15
Anti-tuberculosis
immunity 731
medicines 15
pathogenesis of 637
Anti-tuberculosis drug 5, 214, 276, 342, 440, 458, 621, 624, 626t, 747
absorption of 385
classification of 623t
effects of 295
for adults, doses of first-line 625t
grading of activities of 623t
induced hepatotoxicity
management of 627
risk of 514
induced liver injury, mechanism of 637
newer 629
regimens 406t
resistance 660
surveillance 609620
second-line 350, 385, 724
Anti-tuberculosis therapy 535
incidence of hepatotoxicity with 638
Anti-tuberculosis treatment 167, 189, 214, 218, 236, 247, 253, 272, 276f, 322, 323, 328f, 329, 329f, 364, 414, 442, 448t, 483, 496, 627, 644, 648, 761
acetabulum following 278f
and contraception 351
benefits, assessment of 639
hepatotoxicity with 637643
induced ocular toxicity 342
initiation of 165, 436
principles of 383
regimens, standard 624
standard 290
Aortic valve, continuous Doppler study of 259f
Aortic wall involvement 265f
Aortoarteritis, non-specific 265f
Aphasia, acute onset 234f
Aphthous ulcers 214
Aplasia 445
Aplastic anaemia 443, 448
Appendiceal tuberculosis 131
Appetite, loss of 214
Apple-jelly nodules 302, 303, 331
Aquaporin 434
Arabinogalactan 53
Architectural distortion 124
ARDS See Acute respiratory distress syndrome
Argon plasma coagulation 167
Arogyavaram Medical Centre 5
ART See Antiretroviral treatment
Arterial blood gas 399
Arterial carbon dioxide tension, low 438
Arthritis 550
reactive 295
stage of
advanced 275
early 275
Arthrocentesis 298
Arthrodesis 289
ARV drugs See Anti-retroviral drugs
Ascites 209, 357, 394
amount of 131
Ascitic fluid analysis 215
Asherman's syndrome 135, 365
Aspergilloma 125, 126, 152, 419421, 652
cases of 651
clinical features 421
diagnosis 421
treatment 422
Aspergillus 123, 126, 240, 422, 423, 579
fumigatus 420
lesions 651
species 422
specific immunoglobulin G 421
Aspiration cytology 225
Assmann infiltrates 37
Asthma 151
subacute mimicking 161
Auditory meatus, internal 331f
Aural tuberculosis 330f
Autoimmune
diseases 511
haemolytic anaemia 448
thrombocytopenia 448
Autonephrectomy 369
Autopsy studies, earlier 161
Axillary lymphadenitis 412
Axillary lymphadenopathy, right 558f
Axillary nodes 129
Azathioprine 387
Azithromycin 560, 562, 623
Azotemia 370, 376
B
Bacille Calmette-Guérin 10, 33, 111, 304, 309, 488, 524, 529, 533, 699, 733
immunotherapy 296
induced protection 731
infection 448
recombinant 731
vaccination 309t, 386, 492, 521, 522, 526, 712, 729, 748
side effects of 727
vaccine, history of 727
Bacteraemia 471
catheter-related 550
Bacteria 28, 406
Bacterial endocarditis 240
Bacterial fitness 81
Bacterial infections 151, 420
severe 471
Bacterial meningitis 230
partially-treated 233, 240
Bacterial pneumonia 152, 177
acute 484
Bacteriocins 55
BAL See Bronchoalveolar lavage
Balloon bronchoplasty 167
Barium
meal 497f
studies 210
Bartholin gland
swelling 357
tuberculosis of 356
Bartholin swelling 357
Basal ganglia 45f
Basal meninges, enhancements of 233
Basal meningitis 238
Basal serum cortisol 456
Basic management unit 701
B-cell 26
BCG See Bacille Calmette-Guérin
Bedaquiline 589, 591, 597, 629, 660
Behcet's disease 77, 240, 296
Behçet's syndrome 165
Beta polypeptide 95
Biatrial enlargement 259f
Bidhyarthi Jagarn Manch 694
Bile ductsm, tuberculosis of 225
Bile granulomas 223
Biliary cirrhosis, primary 222, 223, 226, 228
Biliary tract, tuberculosis of 224
Bilirubin, total 640
Biopsies
endometrial 358
multiple 331
Bladder
carcinoma 135
plain X-ray of 369f
Blastomycosis 406
Bleeding 420
manifestations 209
Blood
cells 98
groups, ABO and Rh 74
haemoglobin 531
in stools 214
Blood pressure
control 385
loss of control of 238
B-lymphocytes, role of 65
BMI See Body mass index
BMU See Basic management unit
Body mass index 185, 543
Body temperature 238
Boggy oedema 286
Bone 33, 456
biopsy 445f
erosion 118
tuberculosis of 305f
Bone infection 471
focus of 139
Bone marrow 380, 445
changes in tuberculosis 445, 445t
examination 446
granulomas 445
necrosis 445
suppression 475
trephine biopsy of 416f
Bony ankylosis 278
Boosting vaccines 738
Borrelia burgdorferi 240
Bowel wall abnormalities, detection of 130
Brain 33, 136, 380
lesion, enhancing 243
Breast
cancer 123
carcinoma 124f, 412, 412f
diseases 411
feeding 351
lump 412f
tuberculosis of 411
bilateral 412f
clinical presentation 411
development of 411t
diagnosis 413
differential diagnosis 414
epidemiology 411
open biopsy 414
pathogenesis 411
surgical treatment 414
treatment 414
Breath
shortness of 551
test 151
Britain's arthrodesis 278
Bronchial arteritis 126
Bronchial artery
angiogram 128f
embolisation 420
pseudoaneurysm 125
Bronchial asthma 151, 152
Bronchial carcinoid 406
Bronchial lesions 37, 39
Bronchial obstruction 484
Bronchial stenosis 150, 650
evaluation of 165
Bronchial wall thickening 125
Bronchiectasis 123f, 126, 151153
sicca 126
Bronchiolitis obliterans 125
Bronchoalveolar carcinoma 406
Bronchoalveolar lavage 109, 177f, 204, 400, 524
Bronchogenic carcinoma 151, 152
Bronchography 165
Broncholith 420
Broncholithiasis 125, 205
Bronchopleural fistula 125, 127f, 188, 428, 648
treatment of 649t
Bronchopneumonia 39
Bronchopneumonic tuberculosis, extensive bilateral 123f
Bronchoscopic cryotherapy 168
Bronchoscopic modalities 167
debulking 167
mechanical dilatation 167
thermal debulking using lasers 168
Bronchoscopic secretions 401
Bronchoscopy 151, 163
Bronchostenosis 123, 125
Bronchovascular distribution 123f
Bronchus intermedius 120
Brucella 240
abortus 227
canis 227
melitensis 227
suis 227
Brucellosis 227, 240, 357, 406
Buccal mucosa, tuberculosis of 328f
Bulbar conjunctiva 336
Bullectomy 651
Bullous lung disease, bilateral 424f
C
Cachexia 148
Calcaneum, plain radiograph of 284f
Calcified nodules 244f
Calcium, resorption of 30
Calorie stores 531
Calve's disease 271, 273
Calyceal calcification, bilateral 372f
Cancellous bone grafts 281
Cancer antigen, elevation of 215
Candida 240
Candidate genes 93, 96
studies 97
Capillary walls 435
Capreomycin 350, 386, 598, 618, 623
Carbamazepine 222
Carbohydrate antigens 734
Carcinomatous meningitis 233
Cardiac catheterisation 260
Cardiac tamponade 257f, 258f, 261
development of 254
Cardiac tuberculosis 263
Cardiopulmonary
exercise testing 399
status 650
Cardiovascular diseases 153, 510
Cardiovascular infections 550
Cartridge-based nucleic acid amplification test 9, 186, 215, 236, 272, 322, 363, 466, 469, 552, 591, 618, 720
Caseating granuloma 209, 223, 445
with liquid centre 245
with solid centre 245
Caseating hepatic granulomas 491
Caseating tubercuolma 244f
Caseation necrosis 253
Cauda equina paralysis, severe 274
Cauliflower sign 131
Cavernous sinus thrombosis 557f
Cavitary lesions, bilateral 397f
Cavitary pulmonary tuberculosis 436
Cavity gain 147
Cavity wall 420
CBC See Complete blood count
CBNAAT See Cartridge-based nucleic acid amplification test
Cefoxitin 560
Celiac disease 77
Cell
clara 433
club 433
lung cancer 425
wall lipid bound 54
Cell mediated
autoimmune 444
immunity 33, 78, 97, 179
impaired 47
Central genes 74
Central granular necrosis 27f
Central necrosis 133f
Central necrotic crust 307f
Central nervous system 136, 230, 475, 512, 736
disease 485
Central tuberculosis division 669, 713, 717
Centrilobular nodules 162
Cerebellum 245f
Cerebral artery
middle 232
territory 45
Cerebral oedema 232
Cerebral parenchymal
disease 136
tuberculosis 136
Cerebrospinal fluid 109, 110, 137, 231, 248, 403, 552
parameters 247
study 234
Cervical
cancer 357
disease, severe paralysis from 274
lymph nodes 32, 129, 313, 327
tuberculosis of 326
lymphadenitis 35, 314, 323f
nodes 499
spine 327
radiograph 328f
Cervico-dorsal spine 243f
Cervix 359
tuberculosis of 356
CFTR See Cystic fibrosis transmembrane receptor
Charaka samhita 2
Cheese-like necrosis 28
Chemical exposure 240
Chemokine 64, 82, 87, 433
Chest
computed tomography of 162f
discomfort 216, 435
radiology, role of 106
ultrasonography of 119f
Chest pain 148, 161, 216, 394
atypical 428
Chest signs 357, 394
abnormal 485
Chest wall
abscess, anterior 502f
complications 125, 128
Child with pulmonary tuberculosis 501f
Childhood tuberculosis 721
Chlamydiae 28
Chlorpromazine 222
Chlorpropamide 222
Cholestatic jaundice 395
Cholesterol mediates 66
Chondritis 125
Chondrosarcoma 273
Chordoma 140, 273
Chorioretinitis 138
Choroid plexitis 231
Choroidal granulomas 339
Choroidal tubercles 338, 392, 394
multiple 338f
Choroidal tuberculoma 339f
Choroidal tuberculosis 338
Chromosomes 95
Chronic diseases, symptoms of 2
CHWs See Community health workers
Chylothorax 189, 314
Chylous ascites 314
Chyluria 314
Ciprofloxacin 561, 623
Civil Society Organisations 697, 699, 701
Clarithromycin 560, 562, 623
Clofazimine 561, 564, 591, 596, 623, 627
Club sandwich sign 131
Coagulation abnormalities 445
Coal worker pneumoconiosis 205
Coccidioides immitis 227, 240
Coccidioidomycosis 406
Cold abscess 268, 269, 273
formation of 268
in chest wall 651
Colon
ascending 214
descending 214
Combat tuberculosis, immunotherapeutic approach to 736
Communicable disease 760
Communication and community awareness disease 689
Communication technologies 21
Communities and household settings 760
Community acquired pneumonia 459
Community health
education and advocacy for 693
worker 698, 699, 701
Community volunteers 701
Community-based
directly observed treatment short course 693
implementation, Bangladesh 693
organisations 697
tuberculosis
activities 697, 698, 698t, 700
integrating 697703
Complete blood count 545
Complex genes, major histocompatibility 75, 76
Complex infectious diseases, genetic dissection of 93
Computed tomography 113, 114, 124, 126, 135, 138, 141, 142, 246, 320, 553
Condyloma acuminata 357
Condyloma lata 357
Congenic strains 95
Congenital diseases 151
Congenital disorders 123
Congestive heart failure 395, 512
Conglomerate ring enhancing lesions 242f
Conglomerate tuberculomas 244f
Conjunctiva 32, 336
Conjunctival granulomas, types of 336
Conjunctival infection 336
Conjunctival tuberculosis 336
Connective tissue disorders 123, 240
Constipation 209, 214
Constitutional symptoms 513
Constrictive pericarditis 125, 259f
chronic 255, 257f, 258f, 259f
Contiguous disease 336
Contrast-enhanced computed tomography 115117, 127, 132136, 150, 244, 265, 271, 497
Coomb's test 448
Cord, anterior compression of 272f
Corneal tuberculosis 337
Cornual occlusion, bilateral 360f
Cor-pulmonale
chronic 419, 427
diagnosis of chronic 427
Corpus callosum 45f
Corticosteroid 92, 166, 405, 440, 491
role of 237
short-courses of 491
treatment 228
role of adjuvant 261
Cough 2, 394, 402f, 551
chronic 209
etiquette 525
suppressants 203
Cranial nerve palsies 238
Cranial tuberculosis meningitis, complication of 136
C-reactive protein 420, 443
Crohn's disease 27, 40, 40t, 77, 116, 131, 131t, 165, 213, 214, 214t, 228, 357, 542, 546
in humans 542
Cryptic miliary tuberculosis 511
Cryptococcal meningitis 233
Cryptococcosis 227, 406
Cryptococcus neoformans 240
Cryptosporidium 52
Crystalline silica, phagocytosis of 204
Crystalline silicon dioxide 200
CSF See Cerebrospinal fluid
CSOs See Civil Society Organisations
CTD See Central TB division
Culture filtrate proteins 182, 734
Culture-based tests 584
Culture-negative sputum 533
Cushing's syndrome 308f
Cutaneous lesions 308
Cutaneous reactions, management of 627
Cutaneous tissue 380
Cutaneous tuberculosis 57, 302312
clinical features 302
clinical varieties of 303t
epidemiology 302
laboratory diagnosis 308
treatment 310
CVs See Community volunteers
Cyanosis 394
Cyclopentyl-substituted rifamycin 631
Cyclophosphamide 135
Cycloserine 385, 386, 448, 610, 623, 624, 627
Cyclosporine 380
Cyclosporine-based protocols 380
Cystectomy 376f
Cystic angiomatosis 140
Cystic fibrosis 564
transmembrane
conductance regulator 434
receptor 543
Cystic lesions 142
Cystic lung lesions, multiple 125
Cystitis 495
Cystogram 376f
Cystoscopy 374
Cytokines 64, 82
role of 62
Cytomegalovirus 123, 227
Cytotoxic drugs 394
D
Darrach's procedure 289
de Novo biosynthesis 733
Deep vein thrombosis 395, 442, 445
Deoxyribonucleic acid 52, 107, 521, 560, 622, 728, 733, 763
vaccine 734
immunotherapy 736
Designated microscopy centre 671, 764
Diabetes 509, 532
insipidus 239, 453
Diabetes mellitus 77, 151, 459f, 509, 530, 668, 721
and tuberculosis 459, 530
epidemiology 459
management 460
pathogenesis 460
Diarrhoea 187, 394
chronic 214
Didanosine 475
Directly observed therapy short-course 654
component of 660
evolution of 654
expansion 656
frameworks 654
in global tuberculosis control, role of 654667
programmes 656
role of 654
strategy, original 663
Discharing sinuses, multiple 415f
Disease manifestations and mortality 532
Disseminated disease 33, 217, 224, 545t, 550
Disseminated intravascular coagulation 394, 442, 445, 448
Disseminated tuberculosis
laboratory abnormalities in 395t
signs in 394t
symptoms in 394t
District Drug Stores 725
District Tuberculosis Centre 715, 717
District Tuberculosis Officer 715
DMC See Designated microscopy centre
DNA See Deoxyribonucleic acid
DNTM See Disseminated nontuberculous mycobacterial
Dormancy gene program 733
Dorsolumbar spine 271f
DOTS See Directly observed treatment, short-course
Doughy swelling 279
Doxycycline 560
DR-TB See Drug-resistant tuberculosis
Drug 227
logistics management 724
metabolism 584, 637
request, additional 725
second-line 350
supply and management system, effective 662
susceptibility testing 108, 719
toxicities, monitoring for 566t
Drug-drug interaction 514, 566t, 598t, 599
Drug-resistance
development of 632
develops 582
global surveillance of 613
patterns, individual 618t
testing 11
Drug-resistant tuberculosis 17, 19, 57, 81, 333, 488, 579608, 613, 614, 718, 723, 746, 765
active case finding for 600
adverse effects 596
causes of 579
clinical epidemiology 579
clinical presentation 590
diagnosis of 584, 686
diagnostic algorithm 590f
during pregnancy, treatment of 349
extensively 10, 581, 610, 617, 618, 647
global prevalence of 610
infection control 601
management of 595t, 597, 616, 715, 719
meningitis 238
pathogenesis 582
prevention 600
prognosis 599
programmatic management of 616, 686, 719
services, management of 719
surgery for 597
transmission dynamics of 581
treatment 596, 704
principles of 590
regimens for 597
Drug-sensitive tuberculosis 630t
Drug-susceptibility
microscopic observation 585
testing 11, 107, 110, 560, 579, 586, 617, 716, 764
DST See Drug susceptibility testing
DTC See District Tuberculosis Centre
Duodenum, tuberculosis of 129
Dynein 87
Dysphagia 402f, 510f
Dyspnoea 161, 187, 394, 428
Dysuria, symptoms of 370
E
Eale's disease 335, 340
Eale's vasculitis 340
Ear 327
tuberculosis of 330
clinical manifestations 330
pathogenesis 330
Eastern mediterranean region 20
Ectopic gestation 357
Ectopic pregnancy 365
Eczematous reaction 309
Education programmes and projects 699
Efavirenz 472, 474, 475, 598
Egg shell calcification 202f
Ejaculatory ducts 377
Elbow joint 286
plain radiograph of 288f
tuberculosis of 286
clinical features 286
management 286
pathology 286
radiographic features 286
Electrolyte derangement 598
Electronic tuberculosis surveillance system 663f
ELISA See Enzyme-linked immune sorbent assay
Ellis curve 109f
Embryo transfer 365
Emphysema 148
compensatory 427f
Empyema 118, 126, 471
acute 419
chronic 120f, 419, 428
necessitans 118, 125
Encephalitis 231
Encephalopathy 242f
End tuberculosis strategy 663, 700, 705t, 723
cross-cutting principles of strategy 705
pillars and components 707
Endobronchial
disease 160
granulomas 161
infection, mechanisms of 160
inflammatory tissue 163
Endobronchial tuberculosis 39, 151, 160174, 424
actively caseating 164
chemotherapy of 167
chest radiograph 162
children 165
classification of 163, 164f
clinical course 161
computed tomography 162
diagnosis and treatment of 161
differential diagnosis 165
elderly 165
epidemiology 160
fibrostenotic 164
granular 163
laboratory and radiological investigations 162
macroscopic appearance 161
management of 169
non-specific bronchitic 163
oedematous hyperaemic 163
pathophysiology 160
pregnancy 166
sign of 161
sputum examination 162
treatment 167
tumourous 164
ulcerative 164
Endobronchial ultrasound 169
Endocrine disturbances 238
Endometriosis 357
Endometrium 358
stroma of 355f
Endoplasmic reticulum 76
Endoscopic techniques, newer 212
Endothelial cells 444
Endotracheal intubation 162
Environmental controls, implementing 761
Enzyme 215
Enzyme-linked
immunosorbent assay 106, 108, 111, 181, 235
immunospot assay 181
Eosinophil 28
Eosinophilia 152, 448
Eosinophilic granuloma 140
Ependymitis 216
Epididymis 33, 44
Epididymitis 44
Epithelial cyst 309
Epithelioid cell 29, 39, 223, 226, 231, 437f, 454
clusters of 355f
Epithelioid cell granulomas 36, 44, 223, 320, 398f
confluent 43f
necrotising 38f, 42f
histomorphology of 27f
perivascular 46f
Epituberculosis 36, 147
Epstein-Barr virus infection 78
Erythema
induratum 296, 303, 307, 307f
nodosum 296, 296f, 307, 307f, 309
Erythematous macules 392
Erythrocyte sedimentation, elevated 224
Escherichia coli 371
Etanercept 394
Ethambutol 236, 342, 349, 385, 386, 491, 561, 562, 564, 590, 601, 618, 622627
related ocular toxicity 342
Ethics and law 746f
Ethics in public health, application of 750
Ethionamide 386, 596, 618, 623, 624, 627
Eustachian tube 32
Ewing's sarcoma 123
Ewing's tumour 273
Extracorporeal membrane oxygenation 440
Extra-intestinal manifestations 214
Extraocular muscles 337
Extra-pulmonary cryptococcosis 471
Extra-pulmonary tuberculosis 110, 113, 129, 203, 208, 224, 231, 294, 335, 453, 474, 511, 512, 715, 717
diagnosis of 107
roentgenographic manifestations of 113145
Extrathoracic disease 485
Extrathoracic skeletal muscle 647
Extrathoracic tuberculosis 485
Eye 33, 327
Eyelid
lesion 336
tuberculosis 336
F
Faber's test 289
Facial nerve palsy 329f
Fallopian tube 33, 44, 135, 355, 358, 359f, 360f, 370
tuberculosis 355
Family health international 690, 694
Fatal bronchopneumonia, acute 36
Fatal infectious disease 668
Fatigue 187, 394
FDG See Fluorodeoxyglucose
Female genital tuberculosis 44, 135, 354367
adhesions 362
caseosalpinx 361
chronic stage 362
computed tomography 362
diagnosis of 358, 358t
diagnostic algorithm 364
diagnostic modalities for 358t
differential diagnosis of 357, 357t
hydrosalpinx 361
hysteroscopy 362
laparoscopy 360
magnetic resonance imaging 363
nodular salpingitis 360
patchy salpingitis 361
physical signs 357
positron emission tomography 363
serological tests 363
signs in 357t
subacute stage 360
surgical intervention in 365t
treatment 364
ultrasonography 362
Female reproductive endocrine system, tuberculosis of 461
Femur, proximal 278
Fever 161, 187, 209, 214, 216, 234f, 242f, 248f, 280, 357, 394, 447f
low grade 210, 243f, 402f, 415f
with miliary pattern on chest radiograph, causes of 406t
Fever of unknown origin 414, 415f, 510
diagnosis 414
epidemiology 414
treatment 415
Fibrin ring granulomas 223
Fibrocaseous
cavity, large 284
tuberculosis 37
Fibrosarcoma 273
Fibrosing mediastinitis 125, 128f
Fibrothorax 125, 419, 428
Fibrotic bands 125, 126
Fibrotic parenchyma 132
Fibrous ankylosis 278
Filariasis 357
Fine needle aspiration 717
cytology 124, 134, 320, 414, 490
First-line anti-tuberculosis drugs 475t
in children 491t
mechanism of action of 622t
Fissure, elevated minor 127f
Fistula 370
Fitness cost 584
Flank pain 370
Fleischner sign 130
Fluid restriction 239
Fluid-attenuated inversion recovery 246
Fluorodeoxyglucose 114, 124, 141, 263
Fluoroquinolone 560, 601, 610, 617, 623
FNAC See Fine needle aspiration cytology
Focal bacterial nephritis, acute 135
Focal neurological deficits 238
Folate deficiency 443
Follistatin-like domains 2 87
Foot
plain radiograph of 284f
small bones of 292f
Foreign body 28
aspiration 161
granulomas 26
Four-drug regimen 625
Functional residual capacity 399
Fungal ball 419, 422f
existence of 420
Fungal disease 179
Fungal infection 138, 140, 152, 331, 406
Fusarium 420
Fusiform bird nest paravertebral abscess 139f
G
Gaenslen's test 289
Gallbladder 225
tuberculosis of 225
Galloping consumption 1, 14
Gamma interferon 65
Gas exchange abnormalities 399
Gastric aspirate 107, 108, 110
smear 112
Gastric contents 123
Gastric lavage 110, 403
Gastroduodenal tuberculosis 216
Gastrointestinal bleeding 216
lower 210
Gastrointestinal intolerance 475
Gastrointestinal tract 30, 32
lesions 28
tuberculosis 129
Gastrointestinal tuberculosis 208, 497f
Gatifloxacin 623, 629
Gene
amplification methods 559
knock-in technology 730
knock-out technology 730
probes 559
seven autosomal 95
Generalised tuberculosis 33
Genetic studies 98
in human populations 95
in mice 93
GeneXpert See Xpert MTB/RIF
Genital organs 354
Genital tuberculosis 356t, 370, 374
advanced 365
at laparoscopy, incidence of 361t
minimal 364
Genital ulcers 240
Genitourinary
and skeletal tuberculosis 512
system 132, 380
tract 33, 495
Genitourinary tuberculosis 41, 132, 368378, 495, 496, 504
clinical features of 495t
clinical presentation of 370, 370t, 495
diagnosis 372
epidemiology 368
imaging studies 372
microbiological methods 371
molecular methods 372
pathogenesis 368
role of surgery 496
surgery for 377
surgical interventions in 374t
surgical management of children with 496f
treatment 374
urine examination 371
Genome sequencing 582, 589
Genome-wide
association scans 98
association studies 73, 87, 93
linkage studies 98
Genotype and compensatory mutations 584
Geriatric population 160
Germicidal air-disinfection 762
Ghon's complex 30, 116, 147
Ghon's focus 116, 147
Giant cell 26, 29, 34, 231
multinucleated 226
types of 26
Gingivitis 471
Girdlestone arthroplasty 278
Glands, endometrial 355f
Glandular destruction 458
Glans penis mimicking malignancy, tuberculosis of 371f
Global health emergency 19
Global tuberculosis
incidence rates 706f
strategy 706t, 707t
Glutathione 638
S-transferase gene 638
Gluteal abscess, post-injection 556f
Gluteal region 416f
Glycosylated haemoglobin 156
GM-CSF See Granulocyte macrophage colony stimulating factor
Golf club appearance 359
Gomori's stains 152
Gram's stain, negative 235
Gram-positive
bacteria 53
filaments 152
Granulation tissue 292
formation of 164
Granulocyte 67, 434
cell 379
functions 379
macrophage colony stimulating factor 543
Granuloma 26, 28, 214, 222, 223, 226, 445
aetiology of 27
confluent 29
drug related 228
formation 64, 94
histology of 26
inguinale 357
types of 28, 40, 223
Granulomatoid reaction 223
Granulomatous
diseases 28
inflammatory disease 331
liver disease 226
lymphadenitis 414
myositis 240
pleuritis 178
reaction 309
Granulomatous hepatitis 222229
aetiology 222
causes of 228
clinical presentation 223
diagnosis of 225, 228
differential diagnosis 224
laboratory abnormalities 224
pathology 222
prognosis 228
treatment 228
Granulomatous infection 28t
causes of 26
Granulomatous inflammation 415f
in tuberculosis 27
Graves’ disease 77
Growth factor-β, transforming 63
Guinea pig 54, 729, 730
model 529
of tuberculosis 730
Gyriform hypointensity 245f
Gyriform tuberculoma 245f
H
Haematemesis, massive 395
Haematogenous dissemination 117, 161
Haematologic cancers 511
Haematological changes, drug-induced 448
Haematopoeitic system 566
Haematopoietic bone marrow 509
Haematuria 370
symptoms of 370
Haemodialysis 380
Haemoglobinopathy 140
Haemolytic anaemia 443
Haemophagocytic lymphohistiocytosis 395, 446
Haemophagocytosis 445
Haemoptysis 209, 394, 419, 551, 650
massive 148
Haemorrhage, massive 218
Haemorrhagic eruptions, non-specific 309
Haemospermia 370
Hamstrings spasm 279f
Hand hygiene 525
HCWs See Health care workers
Head and neck 32
tuberculosis 327t, 332, 332t
extranodal 138
Headache 234f, 242f, 248f, 394
Health care
structure 753
workers 520, 524, 525
Health education department 690
Health services, directorate general of 714
Hearing defects 238
Heart failure 427, 428
Heart-lung complex 31f
Hemangioma 138
Hemichorea 238
Hemochromatosis disease 74
HEPA See High-efficiency particulate air
Hepatic adaptation, clinical significance of 638
Hepatic failure, drug induced 224
Hepatic granulomas 222, 223t, 226, 227
causes of 222t, 227t
development of 226
morphological types of 223t
prevalence of 226
Hepatic granulomatous disease 228
Hepatic injury 638
Hepatic lesions 226
Hepatic tuberculosis
lesions 225
primary 224
Hepatic vein, pulse Doppler study of 259f
Hepatitis 222
B 474, 475, 639
infection 226
virus 473, 474
virus infection, chronic 226
C 639
infection 226
virus 474
chronic 226
Hepatobiliary tuberculosis 217, 224226
clinical syndromes of 224t
Hepatocyte
ballooning degeneration of 225f
growth factor 434
Hepatomegaly 394
Hepatotoxic
agents 640
drugs 640
risk mitigation 640
Hepatotoxicity 475, 638
clinical manifestations of 638
development of 237
drug-induced 631
potential risk factors for 639t
risk factors for 639
risk for 639
severe 638
Herpes simplex infection, chronic 471
Heterologous boosting 735
Hibb's arthrodesis 278
High-efficiency particulate air 524
High resolution computed tomography 118, 121, 127
Hip involvement, type of 277f
Hip joint 278f
plain radiograph of 274f278f
tuberculosis of 274
atrophic type 276
clinical features 275
dislocating type 276
management 276
normal type 276
pathology 278
perthes’ type 276
radiographic features 280
radiological types of 277f
Histoplasma capsulatum 227, 240
Histoplasmosis 227, 240
HIV See Human immunodeficiency virus
Hodgkin's disease 222, 228
Hodgkin's lymphoma 227
Homogeneous
enhancement 132
lesions 149
Host's immune system 114
Human genome containing 98
Human immunodeficiency virus 10, 25, 30, 57, 77, 110, 113, 166, 294, 308, 323f, 326, 456, 468, 483, 591, 598, 632, 660, 677, 685, 690, 699, 704, 713, 747, 760, 765
activities 476t
cohorts of 639
co-infection 187, 514, 728
control, youth organisation involved in 694
disease
clinical staging of 471t
progression 77
encephalopathy 471
impact of 685
infected patients 151
infection 5, 92, 128, 148, 166, 226, 232, 238, 253, 315, 423, 448, 466, 522, 540, 596, 609, 639, 644, 685, 685t, 704, 727, 748
during 728
epidemic of 208
impact of 332
stages of 149
tuberculosis in early 469t
people living with 468, 514, 540, 685
positive tuberculosis 472t
prevalence 685t
programmes and projects 699
seropositive 129
globally 16
management of 238
status 238
testing of tuberculosis 477, 720
tuberculosis 468
co-infection 531
during pregnancy, treatment of 350
pathogenesis 468
treatment of 470
wasting in 531
Human leucocyte antigen 77, 97
Human mononuclear macrophages 435
Human nontuberculous mycobacterial pathogens, emerging 551t
Human racial groups 73
Human resources management 723
Human rights
ethics and equity, protection and promotion of 706
groups 689
Human T cells
in vitro 730
lymphotropic virus 78
Human tuberculosis, pathogenesis of 67f
Hy's law 638
Hybrid stents 168
Hydatid disease 273
Hydrocarbons 123
Hydrocephalus 231, 232, 237, 238, 239
Hydronephrosis 135
Hydropneumothorax 125
Hydroureteronephrosis 373f
Hypercalcaemia 395
Hyperinflation, contralateral 125f
Hyperplasia 41
Hyperplastic inflammatory polyps 164
Hyperprolactinaemia 453
Hypersensitivity 56
disease 564
Hyperthyroidism 151
Hypoalbuminemia 513, 599, 639
Hypoglycorrhachia 240
Hypointense masses 363f
Hyponatraemia 232, 239, 440, 455, 512
causes of 239
Hypoplasia 445
Hypoplastic anaemia 443
Hypoproteinaemia 382
Hypotension, severe 456
Hypothalamic disorder 238
Hypothalamo-pituitary 454t
Hypovolaemic shock 456
Hypoxaemia, severe 438
Hypoxaemic ventilatory failure 205
Hysterosalpingogram 360f
I
Iatrogenic rheumatism 294
Ibuprofen 240
ICA See Immunochromatographic assay
Icterus 394
Idiopathic granulomatous hepatitis 228
Idiopathic hepatic granulomas 228
IFNGR See Interferon-gamma receptor
IGRAs See Interferon-gamma release assays
Ileal replacement 374
of ureter 376f
Ileitis, chronic 213f
Ileocaecal
area 214
involvement in tuberculosis 131t
region 130
tuberculosis 130, 497f
Ileum 214
Iliac lymph nodes, external 306f
Iliac lymphadenopathy, external 415f
Iliofemoral arthrodesis 278
Ilium, tuberculosis of 290
Ill-defined parenchymal lesion 487f
Imipenem 560
Immune
activation 469
based tuberculosis tests 108f
complexes, circulating 235
events, adaptive 60
reconstitution inflammatory syndrome 166, 323, 394, 438, 474, 492, 597
regulation 74
response 88
genes 74
status and comorbidities 522
system 87, 734
functioning of 93
thrombocytopenia 444
Immunity 56
acquired 25
adaptive 63
innate 59
protective 59
Immunochromatic test, commercial 718
Immunochromatographic assay 552
Immuno-dominant T-cell 735
Immunoglobulin 108, 182
G 106
M tests 106
production, reduced 529
Immunoinflammatory disorders 406
Immunologic disorders 123
Immunological relatedness, measurements of 522
Immunological tests 235
role of 106
Immuno-modulatory agents 736
Immunosuppressive
agents 339
therapy 526
Immunotherapeutic agents 736
Immunotherapeutic vaccines 738
In vitro
fertilisation 81, 365
proliferation 64
INDEX-TB guidelines 183, 186, 187, 213, 236238, 261, 273, 299, 310, 322, 332, 341, 342, 364, 374, 405, 486, 490, 628, 672, 674, 886960
Indian Medical Association 680
Indinavir 472, 475
Infant born to mother with tuberculosis, management of 491
Infection
control 582
hierarchy 762
measures 612, 765
strategies 759
efforts to avoid 748
intercurrent 147
part of primary 161
subpleural focus of 177
Infectious cases, treatment of 765
Infectious disease 25, 73, 529, 611
chronic 146
control
and tuberculosis 747
legislation for 750
strategies for control of 748t
Infectious tuberculosis 761
Infertility 357
Inflammation, non-suppurative 296
Inflammatory cells 176
Inflammatory cytokine 82
Inflammatory granulomas 504f
Inflammatory process, chronic 209
Inflammatory rheumatological disorders 295
Inflammatory syndrome 597
Infliximab 394
Information technology 658
Infundibular stenosis 132
Inguinal nodes 129
Inhalational prevention strategies 525
Insulin-like growth factor 434
Intense inflammatory reaction 175
Intercarpal joints 289f
Interferon 544
regulatory factor 95
Interferon-alpha 459
Interferon-gamma 63, 96, 215
receptor 544
release assay 106, 109111, 149, 181, 234, 318, 341, 372, 395, 521, 524, 532
Interferon-induced protein 95
Interferon-stimulated gene 544
Interleukin 62, 63, 96, 544
Intermittent treatment, basis of 624
International and National Technical Agencies 689
International Standards for Tuberculosis Care 673, 797885
International Tuberculosis Control Strategy 748
International Union against Tuberculosis 712
Internuclear ophthalmoplegia 238
Interpeduncular cistern 233f
Interstitial keratitis 336
Interventional pulmonary techniques 167
Intestinal colic 209
Intestinal diameter, normal 209
Intestinal lesions 209, 212
Intestinal lumen 212
Intestinal luminal diameter decreases 209
Intestinal obstruction 496
complete 210
partial 210, 214
Intestinal perforation 210
Intestinal tract 226
Intestinal tuberculosis 40, 40t, 208210, 339f, 499f
clinical features 209
complications of 210t
differential diagnosis 214
endoscopy 212
imaging 210
features of 130t
laboratory investigations 210
pathogenesis 208
pathological and clinical correlation 209
pathology 209
site of involvement 209
Intestinal ulcer 496
Intestine 33, 210
decreases 209
small 212
Intra-arterial digital subtraction angiography 421f
Intracardiac masses 395
Intracellular
microorganism 65
pathogen 95
Intracerebral tuberculoma 246t
types of 254t
Intracranial calcifications 238
Intracranial tension 247
Intracranial tuberculomas 230, 241, 504
diagnosis 241
epidemiology 241
management 241
pathology 241
Intramuscular injection 734
Intraocular tuberculosis 335
Intrathoracic tuberculosis 484
lymphadenitis 115
Intravenous
immunoglobulin 548
pyelography 496
urogram 369f, 372f, 376f
Intrinsic immune status 522
Invasive aspergillosis 152
Iodophendylate dye 240
IPT See Isoniazid preventive therapy
Iron 532
smelting 200
Irritative voiding symptoms 370
Ischaemic enteritis 41
Ischiopubic ramus, tuberculosis of 290
Ischium, tuberculosis of 290
Isoenzyme and protein electropherograms 557
Isointense masses 264f
Isolation rooms, negative-pressure 761
Isoniazid 236, 240, 342, 349, 384, 386, 448, 491, 535, 564, 583, 590, 596, 613, 618, 621627, 630, 632
cavities 425
induced peripheral neuropathy, risk of 237
metabolites of 384
preventive
therapy 466, 632
treatment 111
resistant tuberculosis, risk for 632
therapy, preventive 526
J
Janus kinase 544
Johne's bacillus 57
Johne's disease 542
Joint
infection 471
tenderness 286
Jugular venous pressure 254, 428
Juvenile idiopathic arthritis 295
K
Kanamycin 350, 386, 590, 618, 623
Kaplan-Meier analysis 380
Kaposi's sarcoma 166, 471
Kartagener's syndrome 123
Keloid 309
Kenya's drug-susceptible 663f
Keratitis 550
Keratoconjunctivitis 33, 336
Keratotic boot 305f
Kidney 33, 384, 456
disease 668
chronic 379, 384t, 387
plain X-ray of 369f
ureter and bladder 370
Knee joint 281, 380
plain radiograph of 280f, 281f
radiograph of 297f
tuberculosis of 278, 281f
clinical features 279
management 280
pathology 278
radiographic features 280
Koch's lymph 4
Koch's phenomenon 56
Koenig's syndrome 40
Krishna Yajurveda Samhita 2f
Kyphotic deformity, severe 269
L
Lacrimal gland 337
Lacrimal system, tuberculosis of 337
Lamivudine 474
Langerhan's cell histiocytosis 273
Langhans’ giant cells 39, 41, 253, 446, 446t
Laparoscopy 215
role of 499
Larva migrans 240
Laryngeal disease 332
Laryngeal tuberculosis 329f
Laryngitis, chronic 332
Larynx 328
tuberculosis of 328
clinical features 329
epidemiology 328
pathogenesis 328
pathology 328
Latent tuberculosis infection 106, 108, 110, 111, 631, 640
diagnosis of 110
dosages of drugs for 632t
in elderly 514
newer regimens for 631
shorter regimens for treatment of 632
testing and management 110f
treatment 351, 386, 526, 631, 639
options for 632t
regimens for 632t
LED-FM See Light emitting diode-fluorescent microscopy
Left knee joint, flexion deformity of 279f
Left ventricular
end-diastolic pressures 260
pressure tracing 264
systolic pressure 260
Legionella 29
micdadei 52
Legionellosis 406
Leprosy 9f, 93, 227, 331, 357
Leptospira icterohaemorrhagiae 240
Lesion 39
lobar and segmental 36
multiple ring 246f
post-primary 147
primary 35, 147, 336
Leucocyte changes 444
Leucocytosis 395, 442
mild 444
Leucopenia 394, 442, 448
development of 379
Leukaemoid reaction 394, 444, 511
Levofloxacin 386, 618, 623
Lichen scrofulosorum 303, 306, 307f
Light emitting diode 11, 107
fluorescent microscopy 586
Line probe assay 10, 11, 29, 108, 341, 401, 470, 552, 559, 581, 586, 588591, 616, 628, 716, 717, 719
Linezolid 560, 629
Lipid patterns 557
Lipogranulomas 223
Listeria 240
monocytogenes 733
Live attenuated mutants 733
Liver 32, 222, 456
disease 640, 668
pre-existing chronic 639
tuberculosis of 41
Lobar distribution 134
Lobectomy 651
Lobular pneumonia 37
Loculated encysted empyema 503f
Lowenstein-Jensen media 552
Lower abdominal pain, chronic 357
Lower lobe 155
consolidation 532
lesions 510
Lower lung
field bacterial pneumonia 156
field tuberculosis 155159
prevalence of 156t
terminology of 155
zones 202
LTBI See Latent tuberculosis infection
Lumbosacral spine 270f
plain radiograph of 272f
Luminal imaging 210
Lump
abdominal 357
appendicular 357
Lung 31
abscess 152
biopsies 38f
cancer 205, 425
carcinoma 406
cavities 2
cough 1
destroyed 428
left 502f
destruction, extensive 125, 126
disease 547
disseminated calcification of 419
fever 1
function 187
primary 231
type of 426
injury, acute 432
lower zones of 203
middle zones of 203
physical examination of 2
surgery, resectional 647
tuberculosis, whole 39
Lupus vulgaris 1, 303, 303f, 304, 304f, 308, 336
of ear lobe 304f
of external ear 330
Lyme disease 240
Lymph node 33, 110, 114, 117, 135, 142, 148, 402f
biopsy 398f
calcification of 149
caseous 36
cervical and axillary 305f
characterisation of 115t
enlarged 484
enlargement 209, 216
granulomas 40
intrathoracic 500f
mesenteric 209
multiple enlarged hypoechoic 133f
paratracheal 115f
peri-pancreatic 217
regional 35
sampling, indications for 500t
subcarinal 116f
tracheobronchial 30
Lymph node tuberculosis 129, 313325
abdominal 131
clinical presentation 314
cytopathology 319
diagnosis of 317, 319, 321
differential diagnosis 317
epidemiology 313
histopathology 319
imaging 318
in HIV-negative patients 317t
in HIV-positive patients 317t
microbiological methods 321
paediatric 490f
pathogenesis 313
physical appearance of 317t
serodiagnostic methods 322
treatment 322
Lymphadenitis 348, 499, 564
reactive 317
Lymphadenopathy 114, 357, 394, 546
abdominal 447f
hilar 125
intra-abdominal 397
intrathoracic 157
mediastinal 532
residual 327f
subcarinal 265f
tracheobronchial 147
Lymphangitis carcinomatosa 406
Lymphatic spread 161
Lymphocyte 454, 529
and plasma cells 231
count 449
in pleural fluid 175
transfer 529
Lymphocytic infiltration 355f
Lymphocytic meningitis, chronic benign 240
Lymphocytopenia 442
Lymphogranuloma venereum 131
Lymphoid tissues 64
Lymphoma 138, 273, 406
Lymphomatoid granulomatosis 406
Lymphoproliferative diseases 240
Lymphoproliferative disorders 406
M
M/XDR-TB See Multidrug and extensively drug-resistant tuberculosis
MAC See Mycobacterium avium complex
MacConkey agar 557
Macrocytic anaemia 443
Macronodular splenic tuberculosis 134f
Macronutrient interventions 533
Macrophage 454
activation syndrome 446
inflammatory protein 176
T-cell interaction 62
Magnetic resonance 135, 137, 138, 246
imaging 114, 135, 244, 246, 363f
of brain 234f, 243f, 245f, 400f
of dorsolumbar spine 272f
spectroscopy 243f
Male genital
tract 44
tuberculosis 135
Male reproductive endocrine system, tuberculosis of 461
Malignant disease 147
Malnutrition 210, 640
Managerial activities, facility-level 765
Mantoux technique 111
Massive pleural effusion, causes of 177
Maternal and Child Health Programmes 699
MDR-TB See Multidrug-resistant TB
Measles virus 28
Mechanical ventilation 161, 440
systems 762
Mediastinal complications 125, 127
Mediastinal lymph node 31, 33, 36
tuberculosis in children 651
Mediastinal soft tissue 128f
Mediastinal sonography 116
Mediastinal tuberculosis, treatment of 323
Medical Colleges in Tuberculosis Control, role of 668675
Medicines Regulatory Authority 690
Megaloblastic anaemia 448
Megaloblastoid maturation 445
Melanoma 138
Melioidosis 406
Mendelian susceptibility 93, 95
Meningeal enhancement 233f, 234f
abnormal 137f
Meningeal irritation, signs of 232
Meningeal tuberculosis 348
Meningeal veins 231
Meninges 33, 136
enhancement of 248f
Meningitis 231, 392, 471
causes of chronic 240t
chronic 239, 240
aetiology 239
clinical evaluation 240
diagnostic evaluation 240
management 240
syndrome, acute 232
Menstrual pattern 357
Mental dullness 510
Mesenteric tuberculosis 130
Mesothelial cells 39, 176, 178
Metal stents 168
Metastases 132, 138
Metastatic carcinoma 225, 406
MGIT See Mycobacteria growth indicator tube
Microbiological tests 212, 235
Microgranulomas 223
Micronutrient 534
deficiencies 531
Microscopic haematuria 371
Mid-foot swelling 282f
Migrating acetabulum, development of 277
Miliary
disease 35, 328
lesions 397
nodules 531
pattern 396f
tubercles 33, 138
Miliary tuberculosis 33, 39, 67, 114, 118f, 150, 152, 224, 225, 337f, 338f, 391, 392, 394t, 395t, 396f, 400f, 404, 407f, 435, 455, 484, 511
classical 395t
clinical presentation 392
complications 406
cryptic 395t
diagnosis 401
differential diagnosis 403
epidemiology of 391, 391t
gross pathology of 393f
laboratory abnormalities in 395t
laboratory findings 394
manifests 511
molecular methods 401
of skin 303f
acute 303
pathogenesis 392
prognosis 407
signs in 394t
symptoms in 394t
treatment 403
Mimicking pyelonephritis, acute presentation 370
Ministry of Health and Family Welfare 669, 713, 723
Mitral inflow 258f
Mitral valve, pulse Doppler study of 258f, 259f
M-mode echocardiogram 258f
Model Rural Health Research Unit 9
MODS See Microscopic observation drug-susceptibility
Molecular genetics 74
Molecular methods 236
Molecular typing 55
Mollaret's meningitis 240
Money bag sign 260f
Monocyte chemoattractant protein-1 82
Monocytopenia 442
Monocytosis 442
MO-TC See Medical Officer Tuberculosis Centre
Moxifloxacin 385, 590, 596, 618, 623, 629
MRI See Magnetic resonance imaging
MTB See Mycobacterium tuberculosis
Mucosal biopsy 212
Mucosal inflammation 169
Mucosal invasion, superficial 130
Mucosal lesions, biopsy of 332
Multibacillary leprosy 81
Multidisciplinary multimodality management 169
Multidrug and extensively drug-resistant tuberculosis 720
treatment of 710, 719
Multidrug-resistant
organisms 167
pulmonary tuberculosis 150f
Multidrug-resistant tuberculosis 10, 15, 57, 108, 110, 128, 209, 230, 476, 583, 617, 631, 647, 685, 704, 713, 717, 723, 760
diagnosis of 627, 719t
management of 350, 673, 679
prevalence of 616f
treatment of 599, 710
Multifocal fibrosis 202f
Muscle
atrophy 267
mass 531
spasm fixes 284
Musculoskeletal diseases 296
Musculoskeletal manifestations 294
of tuberculosis 294301
Musculoskeletal tuberculosis 46, 138, 294
diagnosis of 297
unusual manifestations of 296
Mycetoma 420, 423
in tuberculosis cavity 126f
Mycobacteria 28, 47, 5258, 152, 320, 406, 435, 540, 544
atypical 540
classification of 52, 52t
cultivation of 54
growth indicator tube 560, 717
growth inhibitor 554
methods of demonstration of 29t
producing skin ulcers 57
release of 524
soluble antigen sharing in 54t
survival of 53
Mycobacterial
antibodies 235
antigens 63, 235, 437, 730
cell wall 53
components 55t
deoxyribonucleic acid 303f
disease 9, 9f, 81, 93, 95, 674
growth inhibitor tube 586
isolation 358
lymphadenitis 313
pathogens, emerging new 550
products, biochemical detection of 236
protein 176
vaccines, atypical 734
Mycobacterial culture 109, 156, 358t, 660
and drug-susceptibility testing 321
diagnostic methods of smear and 486
molecular diagnostic methods 298
Mycobacterial infection 188, 203, 731
atypical 116
Mycobacteriophages 55
Mycobacterium 28, 52, 67, 456, 540, 728
abscessus 540, 543, 549, 560
arupense 541, 548
atypical 165
boenickei 541
bohemicum 541
bolletti 541
brisbanense 541
canariasense 541
celatum 540, 541
chelonae 310, 387, 550, 559, 560
chelonei 297
chimaera 546
colombiense 546
conceptionense 549
conspicuum 540, 541
diernhoferi 541
elephantis 541
europaeum 547, 548
florentinum 544547
genavense 47, 540, 541, 547
gordonae 52, 541
habana 541, 734
haemophilum 541, 548, 554
heckeshornense 541
heidelbergense 547
houstonense 541
immunogenum 541
indicus pranii 261, 734
infection, prevalence of 756
interjectum 541, 547
intracellulare 188, 541, 546, 559
kumamotonense 548
lentiflavum 547
lepraemurium 52
longobardum 548
macrophage interactions 59
mageritense 549
malmoense 541, 550
marinum 52, 57, 309, 541, 548, 554
mucogenicum 541, 549
neoaurum 541
neworleansense 541
nonchromogenicum 541, 548
palustre 541
parascrofulaceum 541, 547
paratuberculosis 52, 57, 541, 559
parmense 541
peregrinum 549
phocaicum 541
porcinum 541, 549
pseudoshottii 541
scrofulaceum 305, 541, 547, 559
senegalense 549
senuense 548
septicum 541, 549
shottsii 541
smegmatis 52, 57, 541
species 738
stomatepiae 547
szulgai 541, 548
thermoresistibile 541
triplex 547
triviale 548
ulcerans 52, 57, 309, 541, 550
vaccae 541, 584, 736
wolinskyi 541
Mycobacterium avium 123, 188, 541, 542, 546, 557, 559
complex 305, 540, 545, 552
disease 564
infections 561
intracellulare 52, 188, 203, 297, 387, 448
complex 47, 227, 324, 541
infection 423
Mycobacterium bovis 29, 52, 291, 540, 727, 737
infection 737
Mycobacterium fortuitum 297, 310, 387, 549, 560
group 549
third biovariant complex 541, 549
Mycobacterium kansasii 47, 52, 188, 203, 387, 540, 541, 546
disease 204
Mycobacterium leprae 29, 52, 540, 736
protein of 734
Mycobacterium simiae 541, 547
complex 547
Mycobacterium terrae 548
complex 541, 548
Mycobacterium tuberculosis 2, 15, 52, 73, 107, 114, 123, 146, 146f, 149f, 158, 188, 208, 226, 240, 268, 294, 302, 335, 348, 368, 394, 411, 420, 468, 483, 534, 540, 545, 585, 587t, 609, 615t, 621, 710, 747, 755, 760
antigenic structure 54
antigens of 733
atypical clinical manifestations in 395t
auxotrophs of 733
bacteria 582
biochemical properties 54
complex 759, 763
culture characters 53
discoverer of 3f
genome 586
infection 59, 93, 94, 95, 443, 484, 648, 727, 730
dose of 731
reverse genetic of 94
stages of 732f
isolates 615t
morphology 52
mutants, development of 733
pathogenesis 55
physical and chemical agents 54
preparation of liquid suspensions of 764
receptor 87
transmission of 523
virulence in animals 54
Mycobacterium xenopi 297, 541, 547
pulmonary disease 562, 565t
severe 565
Mycolic acids 53
Mycophenolate 380
Mycoplasma pneumonia 406
Mycotic aneurysm of aorta 395
Myelofibrosis 446
Myeloid hyperplasia 445
Myeloma, multiple 140, 273
Myelopathy, progressive 243f
Myelophthisic anaemia 443
Myocarditis 395
Myocobacterial lymphadenitis 313
Myoedema 148
Myoplasty, indications for 649t
Myotactic irritability 148
N
NACO See National AIDS Control Organisation
NACP See National AIDS Control Programme
Narcolepsy 77
Nasal tuberculosis 331
Nasopharynx 327, 486
tuberculosis of 330
National AIDS Control
Council 690
Organisation 467, 468, 724
Programme 466, 467, 468, 474t, 477, 720
National Antituberculosis Drug-Resistance Survey 9, 614
National Family Health Survey 531
National Health Mission 725
National Immunisation Programme 690
National Informatics Centre 724
National Institute for Research in Tuberculosis 5, 616f, 684
National Institute of Tuberculosis and Respiratory Diseases 8, 9f, 674, 713
National Japanese Leprosy Mission 713
National Policy on Universal Health Coverage 709
National Programmes for Tuberculosis and Human Immunodeficiency Virus 468
National Public Health Laboratory 690
National Reference Laboratories 716, 717
National Strategic Plan for Tuberculosis Elimination 681
National Tuberculosis Control Programme 8, 684, 687, 712
National Tuberculosis Institute 5, 8, 9f, 669, 684, 713
National Tuberculosis Programme 106, 609, 677680, 701
Natural killer 545
cells 379
T-cells 65
Natural ventilation 761
advantage of 762
evidence-based guidelines on 762
Nausea 209, 394, 638
symptoms of 641
Necrosis 214
Necrotising granulomas 223
Necrotising pulmonary aspergillosis, chronic 152
Necrotising ulcerative stomatitis, acute 471
Nematodes 28
Neoplasms 227, 240
Nephrectomy 375
partial 375, 375
Nephroureterectomy 374, 375, 376f
NET See Neutrophil extracellular trap
Neurocysticercosis 138, 244f, 246t
Neuroimaging 247
Neurological deficit, progressive 247
Neurological deterioration, progressive 240
Neurological disease 340
Neurological infections 138t
Neurological signs 394
Neurological tuberculosis 136, 230252, 503
classification of 230t
diagnosis of 230
prognosis of 247
surgical therapy 503
treatment of 230
Neurosarcoidosis 233
Neurosyphilis 233
Neurotuberculosis 44
Neutropenia 442, 511
Neutrophil extracellular trap 433
Neutrophilia 442
Neutrophils 176
margination of 444
Nevirapine 474, 475, 598
NGOs See Non-Governmental Organisations
Nicotinamide adenine dinucleotide 622
phosphate 95
Night cries 275
Night sweats 187, 209, 280, 394
Nikshay Poshan Yojana 681
Nipple retraction 412f
Nitric oxide synthase 87, 94
Nitrogen intermediates, reactive 61
NK See Natural killer
Nocardia 29, 52, 240
Nocardiosis 406
Nodular lesions 37
Nodular lymphangitis 550
Nodular regenerative hyperplasia 226
Nodular scleritis 337f
Nodular synovitis 298f
Non-caseating granulomas 223, 245, 445
Non-communicable diseases 686
Non-contrast computed tomography 136
Non-genetic factors 92
Non-Governmental Organisations 468, 678, 693, 697, 699
Non-healing wound 370
Non-Hodgkin's lymphoma 227
Non-mycobacterial sepsis 438
Non-opsonised bacilli 59
Non-pathogenic acid-fast bacilli 57
Non-pulmonary infections 540
Non-rifampicin containing regimens 626
Nonsteroidal anti-inflammatory drugs 598
Nontuberculous mycobacteria 47, 52, 57, 95, 111, 146, 167, 188, 222, 253, 296, 309, 318, 447, 449, 540, 541, 545, 551, 552, 560, 733
disease 387, 419, 429, 540, 566t
conditions 562t
diagnostic algorithm for 552f
prevention of 561t
lymphadenitis 318t
Runyon classification of 53t
Nontuberculous mycobacterial
disseminated 545
lung disease, diagnosing 554t
lymphadenitis 315
in children 499
pathology 47
Nontuberculous mycobacterial infection 47, 204, 297, 447, 540579, 648
diagnosis 550
distribution in the environment 540
epidemiology 541
host immune response to 542
management 560
of lung 47
predisposing factors 542
prevention 560
species 541
specimens 553
treatment 560
Normoblastic hyperplasia 448
Nosocomial transmission 522, 760
Notifiable diseases 751
Novel techniques, numbers of 151
NRL See National Reference Laboratory
NTM See Nontuberculous mycobacteria
NTP See National Tuberculosis Programme
Nucleic acid
amplification tests 29, 107, 151, 183, 469, 586
tests 617
Nucleoside reverse transcriptase inhibitors 475
Nucleotide
binding oligomerisation domain-containing protein 728
polymorphism 93
single 461
Nutrition 531
and tuberculosis 529539
epidemiological evidence 530
Nutrition's central role 535
Nutritional deficiency 535
Nutritional interventions with tuberculosis 533
Nutritional partitioning 532
Nutritional recovery 532
Nutritional status 532
protein-related 529
O
Obstetrical complications 348
Obstructive pulmonary disease, chronic 510
Ocular disease 335
Ocular effects 475
Ocular tissues 341
Ocular toxicity 342
Ocular tuberculosis 335345
diagnosis 341
diagnostic categories of 341t
pathology 340
primary 335
secondary 335
serological and molecular methods 341
treatment 341
Odynophagia 216
Oesophageal tuberculosis 129, 216
Oesophagobronchial fistula 125
Oesophagomediastinal fistula 125
Ofloxacin 623
Oligomenorrhoea 362f
Open-negative syndrome 425
Optic chiasma 231, 232
Optic neuritis 630
Opticochiasmatic arachnoiditis 239
Opticochiasmatic pachymeningitis 238
Oral cavity, tuberculosis of 326
Orbital cellulitis, left-sided 557f
Orchiectomy, bilateral 522
Organ dysfunction syndrome, multiple 395
Oropharynx 327
Ortner's syndrome 153
Osteolytic osseous lesions 284
Osteomyelitis 46, 279f, 550
bacterial chronic 291
of left femur 555f
of ribs 651
Osteoporosis 286f
Osteosarcoma 273
Osteotomy, corrective 278
Otomastoiditis 138
Ovarian carcinoma 215
Ovarian malignancy 357
Ovarian tuberculosis 356
Oxazolidinone 599
antibiotic 630
Oxidase 95
Oxygen
administration 440
intermediates, reactive 61
therapy 440
P
Paget's disease 273
PAMP See Pathogen-associated molecular pattern
Pancreatic tuberculosis 132, 217
Pancytopenia 442, 444, 446, 446f, 447f, 448, 511
Panniculitis 296
with tuberculosis 296
Panophthalmitis 337
Papanicolaou's stains 152
Papillary necrosis 369
causes of 135
Papillitis 369
Papillomatosis 165
PAPR See Powered air-purifying respirator
Papulonecrotic tuberculids 303, 306, 307f
Para-aminosalicyclic acid 167, 386, 448, 610, 618, 623, 627
Paradiscal involvement, early changes of 270f
Paradoxical reaction 323
Paragonimiasis 151, 153
Paragonimus westermani 153
Parameningeal infection 233
Paranasal sinuses, tuberculosis of 330
Para-nitrobenzoic acid 557
Paraplegia 268, 269, 273, 332
mild 270
moderate 270
negligible 270
severe 270
Parasites 406
Parasitic infection 153
Paraspinal cold abscess 270f
Paraspinal infection 139
Paratracheal lymphadenopathy, right 500f
Parenchyma 428
Parenchymal abnormalities, resolution of 120
Parenchymal complications 125, 126
Parenchymal consolidation 114
Parenchymal destruction, extensive 427f
Parenchymal disease 167, 177
active 177
co-existing 177
Parenchymal fibroproliferative lesion 121f
Parenchymal infiltrates, extensive 150f
Parenchymal infiltration 149
Parenchymal lesions 117
bilateral 400f
extensive 149f
Parenchymal lung disease 178
Parenchymal tuberculoma 45
Parietal pleural granulomata 179
Parinaud's oculoglandular syndrome 336
Parotid gland swelling 329f
Parotid lymph nodal tuberculosis 499
Parotitis 550
Parrot's law 30
Pars flaccida 330
Particle air, high-efficiency 524, 525
Pathogen-associated molecular pattern 61, 433
PCR See Polymerase chain reaction
Peau de Orange appearance 412f
Pectoral muscles 148
Pelvic dilatation 135
Pelvic infections
acute 357
chronic 357
Pelvic masses 357
Pelvic pain, chronic 356, 363f
Pelvic tuberculosis 361f, 363f
Pelvic vessels 360f
Pelvicalyceal system 135
Pelvicalyectasis 136f
Pelvis, radiograph of 297f
Pentoxyfylline 67
Percutaneous nephrostomy 374
Perianal disease 214
Pericardial biopsy 256
Pericardial effusion 257f
massive 257f
Pericardial fluid 253, 403
Pericardial pain, pathognomonic of 254
Pericardial tuberculosis 140f, 253
Pericardiectomy 261
Pericardiocentesis 261
Pericarditis 253
Pericardium 256f, 380
thickened 259f
calcified 258f
Perilesional oedema 244f, 245f
Perimesencephalic cistern 233f
Perineal sinus 371
Periodic chest radiographs 206
Periodontitis 471
Peripheral airway disease 123
Peripheral blood
decrease in 444
eosinophilia 153
mononuclear cells 436
Peripheral health institutions 715
Peripheral lymph node tuberculosis 314t, 315t, 321t, 499
role of surgery 499
Peripheral lymphocyte infiltration 321f
Peripheral neuropathy 475, 627, 630
Peripheral pulmonary vascular disease 123
Peripheral rim enhancement 319, 397
Peritoneal fluid 403
Peritoneal tuberculosis 41, 208, 214, 215, 498f, 499f
Peritonitis 550
Personal protection measures, use of 762
Perthes’ disease 275
Peyer's patches 41
Phagocytic cells 62
Phagocytic function, abnormal 529
Phagolysosome fusion 60
Pharmacy Council 681
Pharynx, tuberculosis of 330
Phemister's triad 142, 297
Phenomenon, reactive 295
Phenotypic testing, confirmatory 589
Phenylbutazone 222
Phosphate-binding protein 734
Pituitary and tuberculosis 453
Pituitary tuberculomas 454
Plague 1
Planning, department of 690
Plasma
cells 454
pyridoxine levels 535
retinol 531
zinc 531
Plasmacytosis 445
Platelet abnormalities 444
Pleura 428
Pleural based nodular masses 177
Pleural biopsy 179
histology 189
Pleural complications 126
Pleural disease, incidence of 187
Pleural effusion 114, 118, 125, 188, 256, 511
causes of 179
Pleural fluid 110, 178, 179, 401
accumulation of 176
antibody in 182
antigen in 182
levels 185
Pleural lesions 37
Pleural thickening 419, 426
Pleural tuberculosis 39, 511
Pleuropulmonary tuberculosis 647t, 651t
surgery for 644653
current status of surgery 645
incentive spirometry 647
nutritional build-up 645
preoperative preparation 645
preoperative work-up 645
PLHIV See People living with human immunodeficiency viruses
Pneumoconiosis 151, 152, 405f, 406
Pneumocystis jiroveci 47, 152
infection 47
pneumonia 423, 471
treatment of 48
Pneumonectomy 647
Pneumonia 36, 161, 471
alba 147
Pneumothorax 126, 148, 150f, 424
Point-of-care diagnostic tests 151
Polyclonal hypergammaglobulinaemia 401
Polymerase chain reaction 11, 109, 186, 212, 303f, 363, 372, 560
Polymicrobial infection 648
Polymorphonuclear leucocytes 404
Polynesians 455
Polypeptides 610
Polysaccharide antigens 54
Poncet's arthritis, diagnostic criteria for 296t
Poncet's disease 294296
Population attributable fractions 15
Population health, bioethics of 756
Positron emission tomography 113, 114, 124, 141, 142, 320
and fusion modalities 319
computed tomography 263
Post-tuberculosis
bronchiectasis 419, 423
pulmonary destruction 501
Pott's disease 1
Pott's paraplegia, development of 269t
Pouch of Douglas 361f, 362f
Powered air-purifying respirator 524
PPD See Purified protein derivative
Precaval lymph node, large 133f
Prednisolone 237
Predominantly systemic symptoms 123
Preterm delivery 348
Preventive therapy 466
Primary disease, progressive 484
Primary health care, directorate of 690
Prime-boost immunisation strategies 733, 735
Procainamide 222
Proinflammatory cytokines 67
Proliferative arachnoiditis 231
Prosector's wart 302
Prostate 33
Prostatic lesions, hypoattenuating 136
Prosthetic joint, tuberculosis of 292
Protease inhibitors 475, 598
Protein
C, activated 433
deficient guinea pigs 529
derivative, purified 108, 176, 182, 234, 436, 488
energy malnutrition 531
non-secretory 734
tyrosine phosphatase non-receptor type 87
Prothionamide 590, 623, 627
Protozoa 28
Protrusio acetabuli 275, 277f
Provincial and District Health Officers 690
Pseudoaneurysm 128f
Pseudochylothorax 189
Pseudomonas species 584
Pseudotumours 177
Psittacosis 406
Psoas muscle
bilateral 271f
shadow 271
Psoriasis vulgaris 77
Psychiatric and psychological disturbances 238
Public health
and tuberculosis 747
authorities 657
efforts 22
infrastructures 747
Public sector health facilities 676
Puhl's lesion 484
Pulmonary abnormalities 240
Pulmonary alveolar
microlithiasis 405f
proteinosis 205
Pulmonary angiographic image 421f
Pulmonary arterial wedge 260
Pulmonary arteritis 125
Pulmonary artery 315, 427
branch 128f
hypertension 125
pseudoaneurysm 125
Pulmonary aspergilloma 651
Pulmonary disease 188, 335, 429, 545, 546
post-primary 35
Pulmonary function 399
changes 419, 426
Pulmonary hypertension 419, 427
Pulmonary infection, progressive 54
Pulmonary infiltrates, fleeting 152
Pulmonary lesions 438
Pulmonary oedema, protein-rich 433
Pulmonary parenchymal lesions 380
Pulmonary tuberculin test 36
Pulmonary tuberculosis 25, 34, 67, 92, 109, 117, 129, 146154, 177f, 225, 315t, 421f, 427f, 432, 438t, 444, 453, 474, 484, 504, 509, 717
active 230, 326, 445, 449
causes of haemoptysis in 420t
complications of 419431
diagnosis of 149, 151, 155, 469
active 153
diagnostic criteria for 488t
diagnostic mycobacteriology 149
differential diagnosis of 151, 151t
disease 738
haematology 149
healed 427f
paediatric 489f, 490f
pathogenesis of 59
pathology of 34
physical signs 148
post-primary 36, 37t, 155
primary 34, 114t
roentgenographic manifestations of 113145
role of surgery 499
sequelae of 125t
smear-negative 659
smear-positive 659
surgery in childhood 501t
suspects 747
symptoms 147
treatment of 6, 113, 153
upper lobe 156
Pupillary abnormalities 232
Putty kidney 369
Pyeloplasty 374, 375
Pyloric metaplasia 213f
Pyogenic arthritis 142
Pyogenic chronic osteomyelitis 292
Pyogenic infection
low-grade 275
secondary 648, 649
Pyogenic meningitis 234
Pyogenic osteomyelitis, chronic 292
Pyomyositis 471
Pyramidal signs 232
Pyrazinamide 236, 260, 273, 350, 384, 386, 448, 475, 491, 618, 621, 622627, 631, 632, 639
Pyridoxine 236, 535, 627
larger doses of 627
Python sign 362
Pyuria 371
Q
Q fever 212
Quadriceps wasting, early 279f
Quadriparesis 248f
Quality assurance 718
external 107, 670f
for smear microscopy 717
Programme, external 717
Quinolones 560
R
Racial differences 74
Radiation-induced changes 135
Radicular pains 248f
Radiocarpal joints 289f
Rasmussen's aneurysm 126, 128f, 420f
rupture of 420
Reactive oxygen species 433f
Rectovaginal fistula 357
Rectum 214
Red cell aplasia, pure 443, 448
Relapsing polychondritis 163, 165
Renal amyloidosis 43
Renal biopsy 43f
Renal cancer 123
Renal disease, end-stage 379
Renal failure
end-stage 370
on dialysis treatment, chronic 386
Renal function, reduced 386t
Renal insufficiency
chronic 495
complicates 384
Renal mass 370
Renal pelvic traction 132
Renal pelvis 375, 496
Renal toxicity 598
Renal transplant recipients 387
Renal tuberculosis 132
pathologic changes in 369t
Renin-angiotensin system 496
Reno-colo-cutaneous fistula 374f
Respirable silica dusts 200
Respiratory bronchioles 162
Respiratory distress 491
acute 500
Respiratory failure 158, 161, 435
acute 161, 438, 438t
chronic 419, 426
Respiratory hygiene 525, 765
Respiratory pathogens, reduce risk of transmission of 525t
Respiratory protection, personal 763
Respiratory symptoms 148, 166, 513, 761
Respiratory syncytial virus 123
Restriction fragment length polymorphism 560
Reticulin 29
Retinal tuberculosis 340
Retrocaval nodes, small 133f
Revised National Tuberculosis Control Programme 9, 158, 186, 205, 273, 318, 405, 467, 669, 680, 712726
geographical coverage 713f
hierarchical lab network 716f
structure of 713, 714f
RFLP See Restriction fragment length polymorphism
Rhesus monkey 731
case of 731
Rheumatic disease 275
treatment of 295
Rheumatoid arthritis 77, 123, 226, 294
Rheumatological diseases, treatment of 295
Rhinoscleroma 165
Rhodococcus 52
Ribonucleic acid 52, 107, 622, 728
Rice bodies 291
Rickettsiae 28
Rifabutin 560, 562, 564
Rifampicin 108, 236, 349, 384387, 415f, 416f, 448, 456, 460, 514, 545, 562564, 583, 614, 615, 618, 622632
adverse effect of 342
resistant disease 19
resistant tuberculosis 611, 685
Rifamycins 623
Rifapentine 623, 629, 632
Right ventricular
failure 427
outflow tract 264f
pressure tracing 264f
Ritonavir 472, 598
RNA See Ribonucleic acid
RNTCP See Revised National Tuberculosis Control Programme
ROS See Reactive oxygen species
S
Saccharomyces cerevisiae antigens 213
Sacroiliac joint 289, 297f
tuberculosis of 289
Salivary glands 32, 327
tuberculosis of 32, 329
Salmonella 95
containing vacuoles 97
Saprophytic mycobacteria 57
Sarcoid granulomas 240
Sarcoidosis 138, 140, 151, 152, 163, 165, 179, 205, 216, 223, 226, 240, 296, 331, 405f, 406
granulomas 29t
Scapula, tuberculosis of 290
Scar carcinoma 420, 425
Scarred lesions 217
Schachepheth 1
Schirrotic carcinoma 413
Schistosoma
japonicum 227
mansoni 227
Schistosomiasis 227, 357, 406, 728
Scleral tuberculosis 337
Scleritis, cause of 337
Scleroderma 77
Sclerosing encapsulated peritonitis 132f
Sclerosing tuberculosis mastitis 412
Sclerosis, multiple 77
Scrofula 4
Scrofuloderma 302, 303, 304f, 305, 309, 327f
Scrofuloderma overlying tuberculosis 305f
Second-line injectable drugs 617
Secretory antigen-6, early 182
Secretory protein 433f
Seizures 394
and epilepsy 238
Selenium 531
Seminal epidemiological studies 508
Seminal vesicles 377
Sensitivity profiles, determination of 559
Sensorium 394
Septic arthritis 548
Septic shock 395
Serological tests 151, 213, 363, 372
Sero-sanguinous 253
Serum
albumin 382, 531, 599
antibody in 182
antigen in 182
transaminases 224, 225, 640
Sevalanka Foundation 695
Sexual transmission 33
Shasthya Shebikas 693
Short-course chemotherapeutic regimens, evolution of 624
Short-course chemotherapy 146f, 712
regimens 626
Shortening surrogates, treatment 599
Shoulder joint 284, 285
tuberculosis of 284
clinical features 284
management 285
pathology 284
radiographic features 284
Shoulder radiograph 140f
SIADH See Syndrome of inappropriate antidiuretic hormone secretion
Sideroblastic anaemia 443, 448
Sigmoid colon 214
Silica 200
dust 203
Silicon stent
Silicosis 200, 210f, 202f, 204, 204t, 205t, 357
accelerated 201
acute 201
chronic 201
complications of 205t
management 203
pathological diversities of 200
pathophysiology 200
prevalence of 200
radiographic findings 201
risk of 200
simple 201, 203
Silicotuberculosis 200207
clinical features 204
diagnosis 204
epidemiology 203
pathogenesis of 203, 203f
treatment of 205
Simon's focus 484
Sinus 370
chronic non-healing 316f
disease 336
multiple 416
tract 142, 413f
Sjögren's syndrome 77, 123
Skeletal tuberculosis 230, 267293
osseous
exudative type 267
granular type 267
prognosis 268
synovial
exudative type 268
granular type 267
Skin 31, 33, 327
and gums, hyperpigmentation of 627, 627f
rash 475
ulceration 1
Skip lesions 271
SLI See Second-line injectable drugs
Sliced bread appearance 131
Smallpox 1
Smear preparation 764
Smear-negative tuberculosis, treatment of 626
Smoking 579
Sodabicarb 486
Soft tissue
prevertebral 139
swelling 284
Solid viscera, tuberculosis of 208
Solitary choroidal tuberculoma, large 339f
Solitary tuberculoma 338f
Soluble antigen 54
Spectrum agents, narrow 623
Spina ventosa 140
Spinal anaesthesia 166
Spinal arachnoiditis 238
Spinal artery, anterior 650
Spinal block 238
Spinal cord 136
Spinal disease, posterior 274
Spinal infections 46
Spinal tuberculosis 268, 273t
and paraplegia 274t
antibiotics 273
clinical features 269
complications of 268
differential diagnosis 272
infection of bone 268
management 272
pathology of 268
radiographic features 270
surgery 273
Spinal tumour syndrome 274
Spine 380
tuberculosis of 326
Spirometry 163
Spleen 456
tuberculosis of 403
Splenic tuberculosis 217
Splenomegaly 394
Spondylitis 125
Spontaneous pneumothorax 205, 419, 424, 438
Sputum 2, 394, 403, 404
collection 764
container 764
disposal provision 761
production 551
smear 156, 419f
microscopy 747
Squamous cell carcinoma 426
Staphylococcus aureus 46, 123, 295
bacteraemia 406
State Health Society 725
State Tuberculosis Officer 713
State Tuberculosis Training and Demonstration Centre 715
Stavudine 472, 474
Stellate sign 131
Stents, types of 168
Sterile pyuria 370, 371
Sternoclavicular joint, tuberculosis of 290
Sternocleidomastoid muscle 148
Sternotomy, median 261
Sternum and ribs, tuberculosis of 290
Steroid hormone 76
Stierlin sign 130
Stomach, tuberculosis of 129
Stop tuberculosis 654, 694
strategy 656, 656t
Stratified squamous epithelium 32f
Streptomycin 4, 167, 236, 309, 342, 349, 350, 384, 386, 448, 459, 561, 562, 566, 596, 618, 621627
Stricturoplasty 499
Strongyloides stercoralis hyperinfection 406
Subarachnoid space 231
Subchondral sclerosis, minimal 297f
Subclavian artery 421f
Substance abuse 579
Sudden cardiac death 395
Sulphonamides 240, 560
Supraclavicular nodes 129
Surgery, complications of 504
Sutezolid 599
Sweet's syndrome 308
Swelling of finger, spindle-like 295
Sylvian fissure 233f, 234f
regions 137f
Symphysis pubis, tuberculosis of 290
Syndrome of inappropriate anti-diuretic hormone secretion 239
Synovectomy 283, 288
Synovial biopsy 298
Synovial lining 279f
Synovitis, stage of 275, 280f, 286
Syphilis 331, 357
Systemic corticosteroids, efficacy of 187
Systemic lupus erythematosus 77, 226
Systemic mycoses 227
Systemic sepsis, severe 438
T
Tabes mesenterica 41
Tacrolimus 380
Takayasu's arteritis 264
Talcosis 205
Tarsal bones 284f
TB See Tuberculosis
T-cell 65
interaction 78
regulatory 66, 67f
role of effector 63
subsets 63, 64
TDF See Tenofovir disoproxil fumarate
Temporomandibular joint 327
Tendon sheaths 288
Tenofovir 473475
disoproxil fumarate 598
Terminal bronchioles 162
Thalidomide 67
T-helper cells 379
Therapeutic drug monitoring 629
Therapeutic thoracentesis 187
Thiacetazone 624, 627
Thimble bladder 135, 369, 376
small capacity 376f
Thin-walled cavities 125
Thioacetazone 448, 623
Thioamides 610
Thoracic medicine, institute of 614
Thoracic spine, lower 138
Thoracoplasty 651
incision 646f
Thoracoscopic surgery, video-assisted 502, 644
Thrombocytopenia 395, 442, 630
Thrombocytopenic purpura 448
Thrombocytosis 442
Thrombosis 126
Thyroid 327
cold abscess of 458f
effect of anti-tuberculosis treatment on 458
nodule 458f
Thyrotoxicosis 395
Tibio-femoral joint 297f
Tibio-talar joint 298f
Tissue
collection of 107
Doppler study 259f
endometrial 108
T-lymphocyte 529
Tobacco 721
Tobramycin 560
Toll-like receptors 61, 82
Tolmentin 240
Tongue, tuberculosis of 328f
Total hip arthroplasty 278
Toxicity, monitoring for 566
Toxoplasma gondii 240
Toxoplasmosis 138, 227, 406
Trachea, smooth narrowing of 124f
Tracheal stenosis 650
Tracheobronchial complications, treatment for 651
Tracheobronchial obstruction 205
Tracheobronchial stenosis 158
Tracheobronchial tree 120, 163
Tracheobronchopathia osteochondroplastica 165
Tracheopathia osteochondroplastica 163
Tracheo-pulmonary artery fistula 315
Trail's sign 148
Transbronchial lung biopsy 158
Transbronchial needle aspiration 157, 320
Transient synovitis 275
Transitional cell carcinoma 135
Transsphenoidal surgery 454
Traumatic fracture 273
Tree-in-bud appearance 123, 162
causes of 123t
Tree-in-bud pattern 123f
Trematodes 28
Treponema pallidum 240
Trimethoprim-sulphamethoxazole 466, 560
TST See Tuberculin skin test
TU See Tuberculin units
Tubercle bacillus 25, 328
Tubercolosis control 640
Tubercular pleural effusion 513
Tuberculids 303, 306, 309
Tuberculin
conversion 35, 147
positivity 513
skin test 109, 110f, 111, 149, 152, 178, 186, 205, 234, 298, 318, 335, 340, 371, 382, 395, 396, 489, 490, 498, 521, 532, 533, 632
units 488
Tuberculoid leprosy 81
Tuberculoma 37, 45, 114, 117, 117f, 120, 132, 224, 225, 230, 233f, 238, 241, 392
management of 241
ring-enhancing 137f
type of 245
Tuberculoprotein 55, 340, 437
Tuberculosis 335, 405, 437, 453, 483, 501, 523, 529, 668, 728
abdominal lymphadenopathy 113f
abscess 230, 238, 241, 243f, 247, 247t
active 113
activities 476t, 700
implement community-based 698
ageing and risk of 508
and adrenal gland 455
and altered water and electrolyte metabolism 455
and heart 253266
and human immunodeficiency virus infection 466482
and hypercalcaemia 461
and hypothalamus, pituitary involvement 453
and lung associations 689
and non-communicable comorbidities 721
and sick euthyroid syndrome 458
anterior diffuse endophthalmitis 338f
arachnoiditis 230
arteritis and stroke 238
arthritis 142, 282f, 286f
at health care facilities 763
at uncommon body sites 411418
bronchopneumonia 37, 122
burden of 435t
bursitis 291
chancre 302
chemotherapeutic treatment of 532
chemotherapy 623f
centre 7, 8f, 684
classification of 26t
clinical presentation of 513t
co-infected individuals 531
collaborative activities 478
colonic 131
complications of 125, 647
surgery in childhood 504t
concomitant 289
congenital 30, 31f, 224, 348
contagious nature of 520
controlling occupational 523
diagnosis 523
infection control measures 523
preventive strategies 523
treatment 523
corticosteroids in 631
cutis orificialis 306
cystitis 135
detection, samples for 109t
determinants of 14, 709
development of 30t, 295, 380, 436t
diagnosis of 2, 28, 214, 230, 382, 438, 715
diagnosis of active 106, 107t
chest radiology 106
immunological tests 106
sample collection methods 106
diagnosis of types of 717t
diagnostic tests 586t
time-line of 11f
differential diagnosis 28
disseminated 33, 225, 271f, 391, 394t, 392, 400f, 401f, 404
disseminated/miliary 33, 224, 391410, 469
DM collaborative group 721
drug dosage for
adult 718t
paediatric 718t
drugs, use of 679
during maintenance haemodialysis 380
early detection of 524f
effect of pregnancy on 347
effusive-constrictive pericarditis 262f
encephalitis 46f
endobronchitis 420
endocrine implications of 239, 453465
endometrial 355, 355f
enteritis 130, 425
epidemiology of 1324
evaluation of activity of 124
features of active 125t
frequency of 175
genetic
dissection of 92
of susceptibility to 92105
susceptibility parameters in 29, 7391
giant cell suggestive of 398f
global burden of 16
granuloma 445f, 446f
haematological changes in 442t
haematological manifestations of 442452
health care workers, higher risk of 520t
history of 10f, 35
host biomarkers for 67
human immunodeficiency virus collaborative activities 687
immunogenetics of 78
immunology of 56, 5972, 728
immunomodulators in 67
immunopathogenesis of 59
immunopathology of 728
in ancient times 1
in arts and literature 4
in chronic kidney disease 379390
in infants born to mothers with tuberculosis, management of 350
in maintenance haemodialysis 381t
in patients on dialysis, treatment of 385
in recipients of renal transplantation, treatment of 387
in renal transplant patients, clinical presentation of 383t
incidence of 16t, 380
innovative intensified 478
iritis and iridocyclitis 339
laboratory diagnosis of 106112, 151
laryngitis 425
lower lung field 155
bronchoscopy 157
chest radiograph 157
clinical features 156
diagnosis of 158
endobronchial ultrasonography 157
investigations 156
management 158
pathogenesis 156
prevalence 155
signs 156
sputum examination 156
symptoms 156
lymphadenitis 314, 316f, 318t, 321f
mastitis 412
medications 660
meningoencephalitis 45f
microbiologic confirmation of 151
modern chemotherapy for 622t
mortality rates, estimated 17f, 18f
mouse model of 730
musculoskeletal manifestations of 294
myositis 295
natural history of 14, 146, 532
non-human primate model of 731
nutrition on the risk of active 529
on nutrition, impact of active 531
orbital 337
orificial 306f
parotitis 329f
pathogenesis of 29, 146
pathology of 2558
pericardial effusion 257f, 261f
perinatal 30
pleural disease 501, 502
pleural fluid of 65
pleurisy 147
pleuritis 178, 179
pneumonia 36, 148, 436, 437f
post-primary 26, 120, 120f, 122f, 124f, 147
exudative lesion 121
parenchymal disease 121
prevention and management of 533t
primary 29, 31, 32, 33t, 35, 36, 114, 117f, 121, 147, 150, 411, 487
airway involvement 118
complex 30
lymphadenopathy 114
parenchymal lesions 116
pleural involvement 118
progression of 35
progressive primary 26, 35
pulmonary form of 469
pylephlebitis 224
pyomyositis 416
recognition of transmission of 521
regimens 596t
renal transplantation 382
Research Center 7, 614, 669f, 684
risk factors for
risk of 5, 752f
scoring systems for predicting childhood 488
scrotal abscess 370f
sequelae of 125
situation 684
spillage of 156
stopping 654667
stricture, short segment 497f
surgery for 651
complications of 648
surgical aspects of childhood 495505
surveillance 662, 663
synovitis 279f, 280f
tracheitis 424
transmission, decrease 765
transplacental transmission of 348
treatment of 153, 158, 167, 188, 205, 217, 230, 237, 261, 273, 298, 310, 332, 350, 364, 364, 405, 414, 663
unit level (sub-district level) 715
vaccination against 708
verrucosa cutis 304, 304f, 305f
ward 763t
warty 309
well-known victims of 5t
Tuberculosis and endocrine pancreas 460
Tuberculosis and thyroid 456
epidemiology 456
pathogenesis 456
Tuberculosis care 110f
and control 687, 689
ethical issues in 756
regional strategic plan for 687
relevance of partnerships for 687
and prevention 708
collaboration-regulation mix 679
evolution and expansion of public-private mix for 677
financing for 704
global efforts to promote public-private mix 677
in India, standards for 680, 768796
private care providers 677
project, universal access to 680
public-private mix for 676683
scaling up public-private mix 678
standards for 719
strategy-mix to scale up public-private mix 679
Tuberculosis case
bacteriologically confirmed 659
clinically diagnosed 659
in children, new 491t
resistance in previously treated 614
Tuberculosis cervical lymphadenitis 1, 316f, 327f
healed 327f
Tuberculosis control 9, 106, 657f
building partnerships for 684696
changing global face of 9
clarity of roles and responsibilities 689
ethical and legal issues in 746758
beneficence 749
justice 749
law 750
legislation in India 751
non-maleficence 749
ethical issues 751
compliance and adherence 752
direct observation of treatment 753
ethics 748
in east 748
principles and tasks 749
history of 712
in South-East Asia region 684, 692t
information sharing with the partners 689
legal issues 755
high-risk groups 755
prisons 755
partner for 695
Programme in India 725t
progress in 684
resources for 686
response for 684
Tuberculosis disease 491
postpartum 346
severe 641
treatment for active 639
Tuberculosis during pregnancy 346
treatment of active 349
Tuberculosis empyema 649
left-sided 503f
Tuberculosis in children 129, 483494
clinical features 484
complications of surgery for 504
diagnosis of 486, 495
diagnostic algorithm 488
epidemiology 483
natural history 484
transmission 483
treatment 491
Tuberculosis in elderly 506519
adverse effects 513
clinical features of 509
diagnosis 512
drug-resistance 514
epidemiology of 507
general principles 513
re-infection versus re-activation 508
risk factors 509
treatment 513
Tuberculosis in head and neck 326334
region 326
treatment of 332
Tuberculosis in health care workers 520528
category of 521
clinical factors 522
environmental factors 522
level of exposure 522
risk assessment 523
risk of infection 521
Tuberculosis in pregnancy 224, 346353
clinical presentation of 347t
diagnosis 349
epidemiology 346
screening for 347
Tuberculosis infection 60f, 295, 483, 491, 532, 600
control programmes 761
control, national and sub-national 763t
detection of 349
manifestations of 156
risk of 521
Tuberculosis lymphadenopathy 116t
appearance of 115
Tuberculosis meningitis 136, 137f, 231, 232, 232t, 247, 405, 491, 512
cases of 231
clinical features 232
complications of 238, 238t
corticosteroids in 237t
development of 231
diagnosis 233
differential diagnosis of 233t
duration of treatment 237
imaging studies 233
laboratory investigations 233
management of 231t
pathogenesis 231
pathology of 231, 231t
treatment of 236, 238
uncomplicated 236
with hydrocephalus 239t
Tuberculosis notification 9, 681
and surveillance 724
Tuberculosis osteomyelitis 139, 291, 291f, 294, 502f
evidences of 46f
of ulna, healed 291f
Tuberculosis patient
analysis of 92
minority of 755
treated 617t
with health care
provider, relationship of 752
structure, relationship of 753
Tuberculosis pericarditis 253
clinical features 254
clinical symptoms with 254t
computed tomography 260
cross-sectional imaging 260
diagnosis of 256
differential diagnosis 255
echocardiogram 257
electrocardiogram 256
pathogenesis 253
pericardial
biopsy 256
effusion 254
fluid 256
physical signs with 255t
positron emission tomography 260
treatment 260
Tuberculosis pleural effusion 175199, 511
annual incidence of 175
clinical manifestations 177
composite algorithms 185
diagnosis of 178, 180f182f, 184f
imaging 177
immunology 175
natural history 185
pathogenesis 175
pleural biopsy 179
pleural fluid analysis 178
post-primary 177
predictive models 185
serodiagnosis 182
sputum examination 178
thoracoscopy 183
treatment 186
tuberculin skin test 178
Tuberculosis radiculomyelitis 248
clinical features 248
investigations 248
management 249
pathology 248
Tuberculosis sinus
healed 279f, 283f
over lateral malleolus 283f
Tuberculosis spondylitis 138
anterior subperiosteal 139
appendiceal 139
central 139
neural arch 139
paradiskal 138
Tuberculosis strategy
DOTS in stop 657
WHO's new end 704711
Tuberculosis tenosynovitis 291
and bursitis 291
Tuberculosis transmission 760
factors enhancing 760
in health care workers, control of 524t
Tuberculosis treatment 621636, 640
adherence, supporting 689
adverse drug reactions 626
anatomical factors 623
bacteriological factors 621
biochemical factors 623
combinations of drugs 624
drug-resistant 628
ensuring compliance during 628
environmental factors 623
extra-pulmonary 628
fixed-dose combination formulations 629
infectivity during 628
laboratory monitoring during 628
metabolic factor 621
monitoring during 640
numerical factor 621
pharmacological factors 623
scientific basis of 621
Tuberculosis vaccine
development 727745
animal models in 729
for new 738t
impact of zoonosis on 737
impact on 729
in clinical trials 737
strategies for development of 731
Tuberculous
cavity 128f
cocoon 499
pleural effusion 124
Tubercuolma 245f
Tubo-intestinal fistula 357
Tubo-ovarian
abscess 135
and adnexal masses 357
symptoms 209
Tubo-peritoneal fistula 357
Tubo-vesical fistula 334
Tuboplasty 365
Tubular dysfunction 495
Tularaemia 406
Tumour necrosis factor 62, 94, 176, 201
Tumour, primary malignant 132
Turban epiglottis 329
TYK See Tyrosine kinase
Tyler's statement 755
Tympanic membrane, multiple perforations of 330
Typhoid fever 227
Typical tree-in bud nodules 123f
Tyrosine kinase 544f
U
Ulcer 161, 413f
abnormally large 309
chronic non-healing 316f
deep 214
linear 214
multiple 414f, 416f
Ulcerations, formation of 216
Ulceroconstrictive disease 210
causes of 210
Ultrasonography 114
Umbrella sign 210
inverted 130
Union Mission Tuberculosis Sanatorium 5, 6f
United Kingdom, Infectious Disease Notification Act 750
United States Agency for International Development 692, 722
Uraemia 379
Uraemic pleural effusions 185
Uraemic pleurisy 513
Ureter
plain X-ray of 369
stricture of 375
tuberculosis of 135
Ureteral stenting 374
Ureteric obstruction 374
Ureteric pathology 369
Ureteric stricture 374
Ureterocalicostomy 374, 375
Ureteroneocystostomy 374
Ureteropyelogram, retrograde 374f
Urethra, tuberculosis of 374
Urinary bladder 374, 376
tuberculosis 135
surgery for 376
Urinary calculi 370
Urinary fistula 370
Urinary frequency 495
Urinary storage symptoms 370
Urinary symptoms 394
Urinary system 368
Urinary tract 43
infection 495
recurrent 370
tuberculosis of 135
Urine 401
retention of 357
Urothelial wall thickening 136f
Uterocutaneous fistula 357
Uterus, enlarged 377
Uveal tract 336
tuberculosis of 337
Uveitis 138, 240
V
Vaccine
epitope-based 735
induced immune protection 532
priming 738
strain 733
subunit 734
type of 738
Vagina, tuberculosis of 356
Vaginal cancer 357
Vaginal cyst 357
Vaginal discharge, abnormal 357
Vascular complications 125
Vasculitis 240
Vena cava, inferior 259, 258
Ventilation, adequate 525
Ventriculoperitoneal shunts 504
Vertebral disease 269
Vesicovaginal fistula 357
Violent coughing 148
Viomycin 623
Viral hepatitis 639
co-infection 639
Viral meningoencephalitis 233
Virus 28
Visceral tuberculosis 132
Visual loss 238
Vital registration systems 662
Vitamin
A 531, 532, 534, 535
B12 443, 448
deficiency 443
B6 535
deficiency 535
C 531, 534
D 87, 97, 529, 531, 533, 534, 584, 736
and tuberculosis 461
deficiency 461
receptor 87, 97
trials of 534
deficiencies, several 531
E 531
Vogt-Koyanagi-Harada syndrome 240
Vomiting 209, 234f, 456, 638
symptoms of 641
Vulva, tuberculosis of 356
Vulval and vaginal warts 357
Vulval cancer 357
Vulval lesions 357
W
Warthin's tumour 33
Wasting disease 1
Water bottle sign 260f
Watermelon skin sign 136
Weakness 209, 394
Wegener's granulomatosis 165, 331, 422
Weight loss 209, 214, 243f, 254, 314, 347, 381, 394, 471, 511, 531, 590
Welder's pneumoconiosis 205
Whipple's disease 116
White plague 1
WHO See World Health Organization
Wilms’ tumour 87
World Health Organization 3, 13, 20, 106, 107, 110, 182, 347, 403, 406, 471, 474, 585f, 586, 609, 610, 654, 677, 682, 690, 747, 761
tuberculosis report of 704
World Tuberculosis Day Themes 3t
Wrist joint
post-treatment radiograph of 289f
tuberculosis of 288
clinical features 288
management 288
pathology 288
radiographic features 288
X
Xanthogranulomatous pyelonephritis 135
XDR-TB See Extensively drug-resistant tuberculosis
Xpert MTB/RIF 9, 56, 107, 108, 109, 110t, 112, 183, 184, 213, 215, 236, 256, 272, 298, 308, 321, 322, 331, 341, 363, 372, 383, 401, 415, 415f, 416f, 469, 470, 486, 495, 581, 585f, 586, 587, 589, 600, 612, 628, 659, 660
Y
Yersinia enterocolitica 41
Z
Zidovudine 449, 472475
Ziehl-Neelsen stain 152, 256, 371, 486
Zinc 535
deficiencies 529
supplementation 535
Zoonotic diseases 737
Zygomycetes 240, 420
×
Chapter Notes

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History1

Alladi Mohan,
Surendra K Sharma
 
INTRODUCTION
As a destroyer of mankind, tuberculosis has no equal...
VA Moore (1)
Tuberculosis [TB] has been a major cause of suffering and death since times immemorial. Thought to be one of the oldest human diseases, the history of TB is at least as old as the mankind. Over the years, not only the medical implications but also the social and economic impact of TB has been enormous.
There have been references to this ancient scourge in the Vedas [vide infra] and it was called “rajayakshma” [meaning “wasting disease”]. Hippocrates [460-377 B.C.] called the disease “pthisis”, a Greek word which meant “to consume”, “to spit” and “to waste away“ (2,3). The word “consumption” [derived from the Latin word “consumere”] has also been used to describe TB in English literature. The Hebrew word “schachepheth” [meaning “waste away”] has been used in the Bible. J.L. Schonlein, Professor of Medicine at Zurich, is credited to have named the disease “tuberculosis” (1). The word “tuberculosis” is a derivative of the Latin word “tubercula” which means “a small lump” (2,4,5). Several names have been used to refer to TB in the years gone by. Acute progressive TB has been referred to as “galloping consumption”. Pulmonary TB has been referred to as “tabes pulmonali”. Tuberculosis cervical lymphadenitis has been called as “scrofula”, “King's Evil”, “stroma”. Abdominal TB has been called as “tabes mesenterica”. Cutaneous TB has been called “lupus vulgaris”. Vertebral TB has been called as “Pott's disease”. Oliver Wendell Holmes referred to the disease as “white plague” (6). While scores of other diseases like smallpox and plague killed millions of people, their reign has been relatively short-lived. Tuberculosis has been ever present and is resurging with a vengeance.
 
TUBERCULOSIS IN ANCIENT TIMES
It is thought that TB probably existed in cattle before its advent in man.
muncami tva havisa jivanayakam
agnatayaksmad uta rajayakshma...
[I deliver you by means of oblation so that you may live from the unknown disease and from the “rajayakshma”]
[RV, X,161,1]
In the Krishna Yajurveda Samhita, there is reference to how, Soma [Moon] had been affected by “yakshma”. Since “Soma”, who was the “King and Ruler” was affected by “yakshma”, it came to be known as “rajayakshma” [Figure 1.1].
In Sanskrit, the disease has been called “rajayakshma”, “ksayah”, and “sosa”.
Rajayakshma ksayah soso rogarad iti cha smritah
naksatranam, dvijanam cha rajno bhud yad aym pura
yach cha raja cha yakshma cha rajayakshma tato matah
[Vagabhatta, Ast-s and Ast-hrd, Nidana V, 1-2]
Krodho yakshma jvaro roga eko ‘rtho dukhasamjnitah
yasmat sa rajnah prag asid rajayakshma tatomatah
[Charaka Samhita, Chikitsasthanam VIII, 11]
Changes resembling those caused by TB have been described in the skeletal remains of neolithic man (7). Terms such as “lung cough” and “lung fever” have been used in ancient Chinese literature to describe a disease which might have been TB (8). There have been references to what could have been TB in the Code of Hammurabi of the Babylonian era (6). Evidences of TB lesions of bone have also been found in Egyptian mummies dating back to 3400 B.C. (7).2
zoom view
Figure 1.1: Krishna Yajurveda Samhita, II kanda, III prasna, V anuvaka, 25th stanza, where the legend of “Soma” being afflicted with “rajayakshma” is described
Mycobacterium tuberculosis has been demonstrated microscopically in the mummy of a child of five years (8).
There are several references to conditions resembling TB in Greek literature by Homer [800 B.C.], Hippocrates, Aristotle [384-322 B.C.] and Plato [430-347 B.C.], Galen [129-199], Vegetius [420] were also familiar with consumption. Arabic physicians Al Razi [850-953], Ibn Sina [980-1037] correlated lung cavities with skin ulceration.
During the middle ages, there are records of healing touch of monarchs was being used to treat “scrofula” [King's Evil]. King Charles II bestowed the royal touch on an astounding 92,102 patients with “scrofula” (9). By around 1629, death certificates in London specified the disease as “consumption” which was a leading cause of death. By this time the contagious nature of TB was strongly believed though there were people who contested this opinion. The Republic of Lucca is credited to have passed the first legislative action aimed at controlling TB in the world (4,9). This was followed by similar measures in several Italian cities and Spain.
 
DIAGNOSIS
Why, when one comes near consumptives... does one
contract their disease, while one does not contract
dropsy, apoplexy, fever, or many other ills?....
Aristotle
In the early days, diagnosis of TB was based on symptoms and signs. In Charaka Samhita [Nidanasthana, VI, 14], heaviness in the head, coughing, dyspnoea, hoarseness of voice, vomiting of phlegm, spitting of blood, pain in the sides of the chest, grinding pain in the shoulder, fever, diarrhoea and anorexia have been described as the eleven symptoms of TB. Furthermore, a physician who is well versed in the aetiology, clinical presentation and premonitory symptoms of “consumption” was considered to be a “Royal Physician” [Charaka Samhita, Nidanasthana, VI, 17].
The earliest classical descriptions of TB in Greek literature date back to the writings by Hippocrates. Aretaeus the Cappodocian [50 B.C.], in his book The causes and symptoms of chronic diseases gave a very accurate description of TB and mentioned that fever, sweating, fatigue and lassitude were symptoms of the TB. He suggested testing the sputum with fire or water was of diagnostic value (7). Galen described that patients with “consumption” manifest cough, sputum, wasting, chest pain and fever and considered haemoptysis to be pathognomonic of the disease (6).
Following the pioneering efforts by Andreas Vesalius [1514-1564] post-mortem examination was performed frequently. This method of study facilitated understanding of pathological findings, such as, lung cavities, empyema among others. Franciscus de Boe [1614-1672] [also known as Sylvius] for the first time associated small hard nodules discovered in various tissues at autopsy with symptoms of “consumption” which the patients suffered during their life-time though his explanation for the same was not correct (7). John Jacob Manget in 1700 gave the description of classical miliary TB (10). The clinical presentation of consumption was described in detail by Thomas Willis [1621-1675]. Richard Morton [1637-1698] had described several pathological appearances of “pthisis” in his treatise Pthisiologica (46,7).
Meaningful clinical examination became possible with the description of the technique of percussion by Leopold Auenbrugger [1722-1809]. However, Auenbrugger's work was virtually ignored until the time of Jean Nicolas Covisart [1775-1821], who rediscovered and propagated the technique. Gaspard Bayle [1774-1816] accurately described many of the pathological changes of TB, but unfortunately succumbed to the disease which he probably contracted while performing autopsy studies (11). The technique of physical examination of the lung was further refined by the invention of stethoscope by Rene Theophile Hyacinthe Laënnec [1781-1826], who was a student of Corvisart and a friend of Bayle. Sadly, Laennec, his younger brother, mother and two uncles all succumbed to TB (6).
Fracastorius [1443-1553] is credited to have originated the “germ theory” and believed that TB was contagious. He also mentioned about antiseptics in his chapter on the treatment of TB. In 1720, the English physician Benjamin Marten conjectured, in his publication A new theory of consumption, that TB could be caused by “certain species of animalcula or wonderfully minute living creatures”, which, once they had gained a foothold in the body, could generate the lesions and symptoms of the disease.3 He also stated that
“it may be therefore very likely that by an habitual lying in the same bed with a consumptive patient, constantly eating and drinking with him, or by very frequently conversing so nearly as to draw in part of the breath he emits from the lungs, consumption may be caught by a sound person...I imagine that slightly conversing with consumptive patients is seldom or never sufficient to catch the disease” (12)
For unknown reason the work of Marten went into oblivion for a long time. The likely reason could be that he was thinking very much ahead of his time. Jean Antoine Villemin [1827-1892] in a series of experiments provided conclusive evidence that TB was indeed a contagious disease though some workers of that era did not accept these results. He presented his results to the Academie de Medcine on December 5, 1865 and stated that TB was a specific infection caused by an inoculable agent (3,6).
“During my wandering through medicine, I encountered sites where gold was lying around. It needs a lot of serendipity to distinguish gold from ignobility; this, however, is not a particular achievement.”
Robert Koch (13)
Robert Heinrich Herman Koch [Figure 1.2], son of a mining engineer, was born on December 11, 1843 in Clausthal village in the Harz mountains (3,6,14,15). Koch pursued medical studies at the Gottingen University in 1862 and qualified maxima cum laude in 1866 with his M.D. thesis on succinic acid. On March 24, 1882 Koch announced the discovery of the tubercle bacillus during the monthly evening meeting of the Berlin Physiological Society. In 1884, he published a more comprehensive paper Die aetiologic der tuberculose in the second volume of the Reports of the Imperial Health Office. In 1905, he was awarded the Nobel Prize for his contributions in the field of TB research (3,5,6). In 1982, a century after Dr Koch's announcement, the World Health Organization [WHO] and the International Union Against Tuberculosis and Lung Disease [IUATLD], now called The Union proposed the 24th March as the “World TB Day” as a part of a year-long centennial effort under the theme “Defeat TB: Now and Forever.” Thereafter, since 1996, 24th March is celebrated as “World TB Day” every year (16,17). The event was intended to educate the public about the devastating health and economic consequences of TB, and its continued tragic impact on the global health. Each “World TB Day” addresses a different theme [Table 1.1]. Robert Koch died on May 27, 1910, aged 66 years.
It was Robert Koch who finally demystified the secret of the cause of TB and after thousands of years, the organism finally revealed itself to humans. Though, Robert Koch was wrong in his belief that tuberculin would cure TB, tuberculin became an invaluable tool for the diagnosis of latent TB infection (18).
zoom view
Figure 1.2: Robert Koch: the discoverer of Mycobacterium tuberculosisReproduced with permission from “Rubin SA. Tuberculosis. The captain of all these men of death. Radiol Clin North Am 1995;33:619-39 (reference 6)”
Table 1.1   World TB Day themes
Year
World TB Day theme
1997
Use DOTS more widely
1998
DOTS success stories
1999
Stop TB, use DOTS
2000
Forging new partnerships to stop TB
2001
DOTS: TB cure for all
2002
Stop TB, fight poverty
2003
DOTS cured me–It will cure you too!
2004
Every breath counts–stop TB now
2005
Frontline TB care providers: Heroes in the fight against TB
2006
Actions for life–Towards a world free of TB
2007
TB anywhere is TB everywhere
2008
I am stopping TB
2009
I am stopping TB
2010
On the move against TB: Innovate towards action
2011
On the move against TB: Transforming the fight towards elimination
2012
Call for a world free of TB
2013
Stop TB in my lifetime
2014
Reach the three million–A TB test, treatment and cure for all
2015
Gear up to end TB
2016
United to end TB
2017
Let's unite to end TB
2018
Wanted: Leaders for a TB-free world
TB = tuberculosis; DOTS = directly observed treatment, short-course
With the advent of Wilhelm Conrad Roentgen [1845-1923], the technique of radiological imaging became available. Francis Williams in Boston, L. Bouchard and A. Beclere in France, John MacIntyre and David Lawson in Britain were pioneers in the use of radiography in the study of TB (3,6).4 By this time, the deep mystery that was TB became demystified to some extent in that basic concepts of the agent, the pathology as a result of it and its detection became established ushering in the era of definitive diagnosis of TB.
 
TREATMENT
In the Yajurveda, there are references to Soma performing a “yagna” [sacred offering] seeking cure from TB. Since ancient times amulets, invocations, charms, Royal touch and prayers have been used to treat TB. Chemicals such as arsenic, sulphur, calcium, several vegetable, plant and animal products including excreta of humans and animals, blood letting have been used over the centuries in the fond hope of curing TB. Robert Koch, soon after his discovery of the tubercle bacillus, ambitiously introduced the treatment using “Koch's lymph” with disastrous results. It was later known that the substance was a glycerin extract of the tubercle bacillus and was named as “tuberculin” (3,6).
During the 19th century, bed rest and change in environment emerged as important forms of treatment of TB. Hermann Brehmer, Peter Dettweiler, George Bodington, Edward Livingston Trudeau, were all pioneers of the sanatorium movement. Hermann Brehmer, a Botany student suffering from TB, was instructed by his physician to seek out a healthier climate. He travelled to the Himalayan mountains where he could pursue his botanical studies while trying to rid himself of the disease. He returned home cured and began to study medicine. In 1854, he presented his doctoral dissertation bearing the title, “Tuberculosis is a curable disease”. In the same year, he built an institution in GÖrbersdorf where, in the midst of fir trees, and with good nutrition, patients were exposed on their balconies to continuous fresh air. This set up became the blueprint for the subsequent development of sanatoria (12). During this period, surgery was extensively used for the treatment of TB. The reader is referred to the chapter “Surgery for pleuropulmonary tuberculosis” [Chapter 46] for the details.
Efforts by Albert Calmette and his assistant Camille Guérin resulted in the introduction of bacille Calmette-Guérin [BCG] vaccine (19). Pioneering work of Selman Waksman led to the introduction of streptomycin as an effective anti-TB drug. Jorgen Lehman was instrumental in the discovery of para-amino salicylic acid [PAS]. With the availability of these drugs and isoniazid, the era of modern predictably effective treatment ushered in. With the introduction of rifampicin, the treatment duration could be further shortened to the present-day six-month short-course chemotherapy.
 
TUBERCULOSIS IN ARTS AND LITERATURE
Youth grows pale, and spectre thin, and dies
John Keats
Ode to a Nightingale
‘Tis called the evil:
A most miraculous work in this good king;
Which often since my here-remain in England
I have seen him do. How he solicits heaven,
Himself best knows; but strangely visited people,
All swollen and ulcerous, pitiful to the eye,
The mere despair of surgery, he cures,
Hanging a golden stamp about their necks,
Put on with holy prayers; and ’tis spoken,
To the succeeding royalty he leaves
The healing benediction
William Shakespeare
Macbeth, IV, iii, 146
There have been references to TB in several works of fiction. There are references to TB in William Shakespeare's plays such as the “consumptive lover” of Much Ado About Nothing and “scrofula” in Macbeth. Charles Dickens describes the sufferings of Little Blossom in David Copperfield. Thomas Mann's The Magic Mountain contains one of the most well-known descriptions of TB sanatorium. Little Eva of Harriet Beecher Stowe's Uncle Tom's Cabin, Milly Theale in Henry James’ The Wings of the Dove, Marguerite Gautier in Alexander Dumas’ La Dame aux Cameilas also suffered from TB.
TB does not respect anybody. Several important personalities, statesmen, writers, poets, performing artists have been consumed by TB [Table 1.2]. John Keats and Percy Bysshe Shelley symbolised the era of the “romantic consumptive youths of the 19th century” (3). The image of John Keats conveyed by the writings of contemporaries of his era is that of a fragile poet who fell victim to TB because his sensitive nature had been unable to withstand contact with a crude world (3). In a well-known anecdote, when his friend John Brown discovers a drop of blood on the sheet while examining him, Keats says:
“I know the colour of that blood. It's ‘arterial blood’...
That blood is my death warrant, I must die … (3)
Shelley, a fellow poet also suffered from TB pleurisy but did not succumb to the disease. On hearing the passing of Keats, Shelley wrote:
From the contagion of the world's slow stain
He is secure, and now can never mourn
A heart grown cold, a head grown gray in vain;
Nor, when spirit's self has ceased to burn,
With sparkless ashes load an unlamented urn...
The Bronte family included six children all of whom succumbed to TB. Maria and Elizabeth died at a very young age. The son died of consumption, alcohol and opium. Emily [Wuthering Heights] and Charlotte [Jane Eyre] died aged 29 and 39 respectively. It was thought that, their father Rev. Patrick Bronte was the source of infection. The families of Ralph Waldo Emerson and Henry David Thoreau were also wiped out by consumption (3,6).
Several famous Indians had also succumbed to TB. The list includes the famous mathematician Srinivasa Ramanujan, writer Munshi Prem Chand, Kamala Nehru, among others.5
Table 1.2   Well-known victims of tuberculosis
Mathematician
Srinivasa Ramanujan
Doctors
Rene Theophile Hyacinthe Laënnec
Edward Livingston Trudeau
Writers and Poets
Alexander Pope
Samuel Johnson
Jean-Jacques Rousseau
Johann Wolfgang von Goethe
Sir Walter Scott
Percy Bysshe Shelley
John Keats
Leigh Hunt
Elizabeth Barrett Browning
Charlotte Brontë
Emily Brontë
Anne Brontë
Fyodor Dostoevsky
Robert Louis Stevenson
Anton Chekhov
Franz Kafka
Katherine Mansfield
George Orwell
Munshi Prem Chand
Statesmen/Stateswomen
Kamala Nehru
Eleanor Roosevelt
Mohammed Ali Jinnah
Nelson Mandela
Musicians
Frederic Francois Chopin
Niccolo Paganini
Carl Maria von Weber
Performing Artists
Vivien Leigh
Elisa Rachel Felix
Amitabh Bachchan
 
RISK FACTORS
Historically, several genetic, social, environmental and biological determinants of health have been identified as risk factors for TB. Role of genetic factors in the causation of TB has been covered in the chapters “Genetic susceptibility parameters in tuberculosis” [Chapter 6] and “Genetics of susceptibility to tuberculosis” [Chapter 7]. No account of the history of TB would be complete without a reference to this modern foe. The impact of the twin disaster of human immunodeficiency virus [HIV] infection and TB on human suffering has been covered in the chapter “Tuberculosis and human immunodeficiency virus infection” [Chapter 35]. The deadly interaction between diabetes mellitus [DM] and TB is being increasingly recognised world over and has lead to the institution of bi-directional screening for TB and DM (2022). Evidence has become available suggesting that use of immunomodulator drugs [biologicals] has been associated with the development of fatal TB in rheumatoid arthritis (22,23). Data are also emerging suggesting that tobacco smokers have about three-fold higher risk of TB than non-smokers; even after adjustment for other factors (24,25).
 
DRUG-RESISTANT TUBERCULOSIS
With the introduction of anti-TB drugs in the mid-1940s, the era of cure for TB became a reality. Within a short period of about a half-century, the menace of drug-resistant TB [DR-TB] became a serious threat to TB control. The 1990s witnessed mutlidrug-resistant TB [MDR-TB], then the early years of the new millennium have witnessed the menace of extensively drug-resistant TB [XDR-TB]. The impact of X/MDR-TB on TB control is covered in “Drug-resistant tuberculosis” [Chapter 42].
 
INDIA AND TUBERCULOSIS CONTROL
Research carried out in India has had a tremendous impact on TB and this experience has been of immense value in the control of TB worldwide. The first sanatorium in India was started in 1906 in Tilonia, Rajasthan. Subsequently, other sanatoria were set-up in Almora in 1908 and Pendra Road, Central Provinces in Madhya Pradesh, at about the same time. The first sanatorium outside the patronage of Christian missionary organisations, called Hardinge Sanatorium was established at Dharampur, near Shimla in 1909 with the help of donations from some Mumbai-based philanthropists, mainly Parsis, under the banner of the Consumptives’ Homes Society. The first Government-run sanatorium [King Edward Sanatorium] was started at Bhowali in Uttarakhand [Figure 1.3]. The Union Mission Tuberculosis Sanatorium [UMTS] was established in Arogyavaram, Madanapalle, Chittoor district, Andhra Pradesh in 1915 [Figure 1.4A]. With the advent of the National Tuberculosis Programme [NTP] in 1962, the UMTS was converted to a general hospital called the Arogyavaram Medical Centre [Figure 1.4B] which is continuing to function even today. Till the mid-1950s, important TB research activity in India was pioneered by researchers [Figure 1.4C] at the UMTS sanatorium (26,27).
India became a member of the International Union Against Tuberculosis in 1929. From the funds generated in response to the appeal made on behalf of the government by the then Vicereine Lady Linithgow, and the King George V Thanksgiving [Anti-Tuberculosis] Fund, the Tuberculosis Association of India [TAI] was formed in February, 1939. In 1940, the TAI and Government of India jointly set-up the New Delhi Tuberculosis Centre as a model clinic. In 1951, the clinic was upgraded as first TB Training and Demonstration Centre in the country. In 1941, the Lady Linlithgow sanatorium was setup at Kasauli (2629). The subsequent years saw the establishment of the Tuberculosis Chemotherapy Centre [TCC] at Chennai [then called Madras] and the National Tuberculosis Institute [NTI] at Bengaluru [then called Bangalore].
 
National Institute for Research in Tuberculosis, Chennai
In October 1955, on the request of the Government of India, the WHO sponsored the visit to India of three representatives of the British Medical Research Council [BMRC] to advise on studies designed to provide information on the mass domiciliary application of chemotherapy in the treatment of pulmonary TB (30).6
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Figure 1.3: King Edward Sanatorium at Bhowali, Nainital, Uttarakhand state [A,B]. Late Dr Tarachand, originally a physician, who became a famous thoracic surgeon and his wife Dr Shanti Tarachand [expert in anaesthesiology] are well-known names at this Sanatorium. The museum in the sanatorium houses many of the surgically resected gross pathology specimens [C to F]
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Figure 1.4A: Lord Pentland, Governor of the then Madras State opened the Union Mission Tuberculosis Sanatorium at Madanapalle on July 19, 1915, seen along with Dr Christian Frimodt-Moller, the first Medical Superintendent and members of the Governing Body[Kind courtesy: Dr B Wesley, Director, Arogyavaram Medical Centre, Madanapalle]
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Figure 1.4B: The Union Mission Tuberculosis Sanatorium, at Arogyavaram, Madanapalle, Chittoor district, Andhra Pradesh, that later became the Arogyavaram Medical Centre
This was particularly relevant as the number of patients with TB far outnumbered the number of beds available for their admission at that time. It was feared that outpatient treatment might prove inadequate for the treatment of the disease, and that a high proportion of patients so treated might become chronic excretors of drug-resistant organisms and might pose a serious public health risk if use of domiciliary chemotherapy was widespread. With the knowledge then available, it was agreed that it would be premature to begin mass domiciliary application of chemotherapy, even in a limited area. It was finally decided to undertake a controlled comparative study of the treatment of patients at home and in a sanatorium initially, and to follow up the family contacts.7 Patients were to be admitted to study from among those routinely diagnosed by the chest clinic service of a large city. In order to implement these decisions, the TCC was established at Madras [Chennai] in 1956 [Figure 1.5A] as a five-year project, under the joint auspices of the Indian Council of Medical Research [ICMR], the Government of Tamil Nadu, the WHO and the BMRC. This Centre started its activities with eight international staff members belonging to the WHO and a team of national staff members drawn from the ICMR and the Government of Tamil Nadu under the dynamic leadership of Dr Wallace Fox of the BMRC. The Centre was housed in two main blocks, in a one-and-a-quarter hectare campus on Spur Tank Road, Chetput, in the heart of Chennai city. The Centre, which had an initial lease of life of only five years and had faced the threat of closure in 1961, has evolved further. In keeping with the wide sphere of activities of the Centre, the ICMR in 1978 renamed the TCC as the “Tuberculosis Research Centre” [TRC] (30) [Figure 1.5B]. The TRC was renamed on August 1, 2011 as National Institute for Research in Tuberculosis [NIRT] [Figure 1.5C]. Presently, a permanent institute under the ICMR, the NIRT is an internationally recognized institution for TB research. It is a Supranational Reference Laboratory and a WHO Collaborating Centre for TB Research and Training [Figure 1.5D]. Recently, an International Centre for Excellence in Research [ICER], in collaboration with NIH, was established at the Centre.
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Figure 1.4C: Pioneers of research at Union Mission Tuberculosis Sanatorium, Arogyavaram, Madanapalle: Dr PV Benjamin [left panel], Dr Johannes Frimodt-Moller [middle panel], and Dr KT Jesudian [right panel][Kind courtesy: Dr B Wesley, Director, Arogyavaram Medical Centre, Madanapalle]
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Figure 1.5: Tuberculosis Chemotherapy Centre, Madras [Chennai] [A]; Tuberculosis Research Centre, Madras [Chennai] [B]; renaming of Tuberculosis Research Centre as National Institute for Research in Tuberculosis [C,D][Kind courtesy: National Institute for Research in Tuberculosis]
8
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Figure 1.6: Pioneers of research at Tuberculosis Chemotherapy Centre, Madras [Chennai]: Dr Wallace Fox [left panel]; Professor D.A. Mitchison [middle panel]; and Dr Hugh Stott [right panel][Kind courtesy: National Institute for Research in Tuberculosis, Chennai]
 
The Madras Experiment
Pioneering researchers who worked at TCC, TRC, NIRT are shown in Figure 1.6. The findings of the “Home-Sanatorium study” conducted by the TRC, Madras [Chennai], have found their way into several journals and textbooks on TB. The finding that TB patients can be effectively treated as outpatients and continue to live in their homes without added risk to their family contacts has revolutionised the whole concept of the management of TB (30). These pioneering studies also form the conceptual basis for the modern-day “DOTS”.
 
National Tuberculosis Institute
In order to formulate an effective strategy to control TB in India, the NTI was established under Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, at Bengaluru [then, called Bangalore] in 1959, and was formally inaugurated on September 16, 1960 by Pandit Jawaharlal Nehru, the first Prime Minister of India (31). The NTI is located in the northern part of the Bengaluru near Rajamahal Guttahally on a sprawling field of 23 acres of land [Figure 1.7A]. The main central old building of oriental architecture called “Avalon”, was a palace belonging the erstwhile Maharaja of Mysore [Figure 1.7B]. The NTI has grown rapidly and has been designated as the WHO Collaborating Centre for TB research and training since June 1985. The NTI plays an important role in organising training activities in TB control for medical and paramedical personnel, in policies and procedures consistent with the WHO recommended DOTS strategy. Other functions of the NTI include monitoring and supervising TB control programme in the country, to plan, co-ordinate and execute research in TB epidemiology in India.
 
National Institute of Tuberculosis and Respiratory Diseases
The Lala Ram Sarup [LRS] TB hospital was established by TAI in 1952. It was upgraded into an autonomous institute, the LRS Institute of Tuberculosis and Respiratory Diseases under the Ministry of Health and Family Welfare in 1991 by the Government of India. The institute has recently been renamed in 2012 as National Institute of Tuberculosis and Respiratory Diseases [NITRD] (32). The LRS TB hospital functions in the NITRD. The WHO and the Global Laboratory Initiative [GLI] have recently recognised Microbiology Laboratory at NITRD as a National Centre of Excellence in 2014 for the WHO/GLI TB Supranational Reference Laboratory Network. The NITRD [Figure 1.8] has been designated by the WHO as a WHO Collaborating Centre [WHO CC] in TB Training [WHOCC No. IND-128] on November 6, 2014. The NITRD-WHO CC was opened on World TB Day 2015. The NITRD is a key player in TB control in India.
 
National JALMA Institute for Leprosy and Other Mycobacterial Diseases
The India Centre of Japanese Leprosy Mission for Asia [JALMA] was established in Agra by the Japanese in 1963 and was managed by a Tokyo based voluntary organisation JALMA (33). On April 1, 1976 the India Centre of JALMA was officially handed over to the Government of India and subsequently to the ICMR. This was named as Central JALMA Institute for Leprosy in 1976 and has been renamed as “National JALMA Institute for Leprosy and other Mycobacterial Diseases [NJILOMD]” in 2005 [Figure 1.9].
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Figure 1.7: National Tuberculosis Institute, Bengaluru: Entrance [A]; Avalon building [B]
9
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Figure 1.8: National Institute of Tuberculosis and Respiratory Diseases [NITRD], Lala Ram Sarup [LRS] TB hospital, New Delhi
The NJILOMD is equipped with the state-of-the art facilities such as well-equipped laboratories, modern hospital and well-set Field Programmes at Model Rural Health Research Unit [MRHRU] at Ghatampur and a satellite centre at Banda, serves as a National Reference Laboratory [NRL] for TB for 4 states [Assam, Himachal Pradesh, Uttarakhand and Eastern Uttar Pradesh] and repository centre for mycobacterial strains. The institute has a major thrust on research in TB and other mycobacterial diseases (33).
The history of TB and time line of various TB diagnostic tests are shown in Figures 1.10 and 1.11 respectively.
 
Revised National Tuberculosis Control Programme
Considered to be one of the most spectacular cost-effective health interventions ever conceived, the Revised National Tuberculosis Control Programme [RNTCP] of the Government of India, which began in 1997, now covers the whole country. The RNTCP has been the fastest expanding programme, and the largest in the world in terms of patients initiated on treatment. The reader is referred to the chapter “The revised national tuberculosis control programme” [Chapter 53] for details on this topic.
 
Involvement of Medical Colleges in Tuberculosis Control
The RNTCP has the unique distinction of involving medical colleges in TB control (34). This topic is covered in detail in the chapter “The role of medical colleges in tuberculosis control” [Chapter 48].
 
Tuberculosis Notification
In order to have complete information of all TB cases, the Government of India declared TB to be a notifiable disease on May 7, 2012 (35). Accordingly, all health care providers including government, private, non-governmental organisations, individual practitioners are expected to notify TB cases.
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Figure 1.9: National JALMA Institute for Leprosy and other Mycobacterial Diseases, Agra. Inset: Main gate
 
National Antituberculosis Drug-resistance Survey
The RNTCP, in collaboration with the NTI, Bengaluru; U.S. Centers for Disease Control and Prevention and the WHO; has initiated the first national anti-TB drug-resistance survey (36,37). In this survey covering 120 TB units in 24 states, 13 drugs including all first-line and most of second-line anti-TB drugs were tested. The survey was conducted in a representative sample of both newly diagnosed sputum smear-positive pulmonary TB cases [Category I] and previously treated sputum smear-positive pulmonary TB cases [Category II] (36,37).
 
Other New Innovations
Since the beginning, the RNTCP had provided thrice-weekly intermittent treatment (3841). With more recent evidence accumulating, the programme has introduced daily treatment from 2016 and the entire country is being covered in a phased manner. The RNTCP is also scaling up the newer diagnostic modalities, namely, cartridge-based nucleic acid amplification tests [CBNAAT], such as, Xpert MTB/RIF and line probe assay [LPA] for early diagnosis of TB and molecular detection of drug susceptibility. The evidence-based Indian Extrapulmonary TB [INDEX TB] guidelines have been published in 2017 (42). Active case finding in vulnerable populations under the RNTCP is also being studied (43,44). Introduction of newer anti-TB drugs, such as bedaquiline and delamanid under conditional access program, under RNTCP is underway (45).
 
CHANGING GLOBAL FACE OF TUBERCULOSIS CONTROL
The recent paradigm shift in efforts directed at TB control globally is highlighted in the chapters “Building partnerships for tuberculosis control” [Chapter 50], Integrating Community-based Tuberculosis Activities into the Work of Non-governmental and Other Civil Society Organisations [The ENGAGE-TB Approach]” [Chapter 51] and “WHO's new end TB strategy” [Chapter 52].10
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Figure 1.10: A brief history of TB
TB = tuberculosis; BCG = bacille Calmette-Guérin; HIV = human immunodeficiency virus; AIDS = acquired immunodeficiency syndrome; MDR-TB = multidrug-resistant tuberculosis; XDR-TB = extensively drug-resistant tuberculosis; CBNAAT = cartridge-based nucleic acid amplification tests; RNTCP = Revised National Tuberculosis Control Programme; FL-LPA = first-line line probe assay; DST = drug-susceptibility testing; DR-TB = drug-resistant tuberculosis; SL-LPA = second-line line probe assay
 
EPILOGUE
A look at the history of TB [Figure 1.10] and time line of various TB diagnostic tests [Figure 1.11] reveals that it took several thousands of years for humans to identify the causative organism, another 60 years to arrive at effective treatment. Towards the end of the twentieth century, the twin disaster of HIV and TB and X/MDR-TB seem to be on the verge of threatening to ruin the mankind. While it is heatedly debated that TB is “resurging”, this may hold true for the industrialised countries. But in the third-world countries like India, TB never seems to have “disappeared” to “resurge” later. TB has always been with us, only revealing itself every now and then and making us wiser.11
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Figure 1.11: Time-line of various TB diagnostic tests
TB = tuberculosis; LED = light emitting diode; DST = drug-susceptibility testing; PCR = polymerase chain reaction; FL-LPA = first-line line probe assay; SL-LPA = second-line line probe assay; DRT = drug-resistance testing
 
ACKNOWLEDGEMENTS
The authors wish to acknowledge the help rendered by Vedic scholars K Gopala Ghanapatigal, Vedaparayandar, Tirumala Tirupati Devasthanams, Tirupati, and V Swaminatha Iyer, Retired Principal, Kendriya Vidyapeetha, Guruvayoor, Kerala, India, for their invaluable help in tracing the references to TB in the Vedas.
 
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