2. Consider the Following Patient:
John, a 45 year old male, was admitted to the hospital
because of pain in his chest and a persistent cough,
occasionally containing blood. For the past few weeks in
addition to the cough, he has experienced various
symptoms including chills, fatigue, fever, and loss of
appetite. He has been a heavy smoker most of his life.
3. What would be your initial diagnosis for
this patient?
5. Diagnosis and Testing
It has been determined that John has tuberculosis.
TESTING:
Tuberculin Skin Test (Most Common)
PPD tuberculin injected just below skin of forearm
Raised red bump within 48-72 hours indicates positive test
TB Blood Test
Measure immunes system’s response to TB
Imaging Tests
Chest X-ray or CT scan – white spots in lungs
Sputum Tests
Take samples of mucus from coughing
7. What is Tuberculosis biochemically?
Caused by the bacterium Mycobacterium tuberculosis
arabinogalactan (AG)
Essential component of the cell wall
Polymer of arabinogalactin
Biosynthesis occurs via membrane bound
arabinofuranosyltransferases
Structure of Mycobacterium tuberculosis
glutamine synthetase
8. Tuberculosis
Airborne infection that affects the lungs
Contagious
Not everybody develops symptoms
Active and inactive forms (latency)
Potentially fatal if untreated
9. Treatment
Take antibiotics for at least 6-9 months
Isoniazid
Rifampin
Ethambutol
Pyrazinamide
Antibiotics competitively bind to enzymes inhibiting transcription of
mycobacterial cells
10. Sources
Mayo Clinic Staff Print. (2016). Tuberculosis. Retrieved December 19,
2016, from http://www.mayoclinic.org/diseases-
conditions/tuberculosis/diagnosis-treatment/diagnosis/dxc-20188951
Alderwick, L. J., Lloyd, G. S., Lloyd, A. J., Lovering, A. L., Eggeling, L., &
Besra, G. S. (2011). Biochemical characterization of the Mycobacterium
tuberculosis phosphoribosyl-1-pyrophosphate synthetase. Retrieved
December 19, 2016, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055594/
Structure of Mycobacterium tuberculosis glutamine synthetase in
complex with a transition-state mimic provides functional insights. (2005,
March 21). Retrieved December 19, 2016, from
http://www.pnas.org/content/102/30/10499.figures-only
What Is Tuberculosis? Picture, Diagnosis, Causes. (n.d.). Retrieved
December 19, 2016, from
http://www.webmd.com/lung/understanding-tuberculosis-basics
