A client with primary TB infection can expect to develop which of the following conditions?
A. Active TB within 2 weeks
B. Active TB within 1 month
C. A fever that requires hospitalization.
D. A positive skin test.
Correct Answer: D. A positive skin test.
A primary TB infection occurs when the bacillus has successfully invaded the entire body after entering through the lungs. At this point, the bacilli are walled off and skin tests read positive. However, all but infants and immunosuppressed people will remain asymptomatic. The general population has a 10% risk of developing active TB over their lifetime, in many cases because of a break in the body’s immune defenses. The active stage shows the classic symptoms of TB: fever, hemoptysis, and night sweats.
Option A: The tubercle bacilli will proliferate until an effective cell-mediated immune response develops. This usually takes about 2 to 10 weeks following initial infection in more than 90% of infected individuals. In the lungs, failure to mount an effective cell-mediated immune response and tissue repair could lead to extensive damage.
Option B: About 5 % of patients develop primary active tuberculosis secondary to inadequate T-cell immunity. About 5-10% of patients with latent infections progress to active disease in their lifetime, most commonly in the initial two years. If untreated, half of those with the active disease die.
Option C: In pulmonary tuberculosis, the most commonly reported symptom is a chronic cough. Cough most of the time is productive, sometimes mixed with blood. Constitutional symptoms like fever, weight loss, lymphadenopathy, and night sweats are commonly reported.
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