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During active disease, some of these cavities are joined to the air passages bronchi and this material can be coughed up.
It contains living bacteria, so can spread the infection.
Macrophages, T lymphocytes, B lymphocytes, and fibroblasts aggregate to form granulomas, with lymphocytes surrounding the infected macrophages.
When other macrophages attack the infected macrophage, they fuse together to form a giant multinucleated cell in the alveolar lumen.
Treatment with appropriate antibiotics kills bacteria and allows healing to take place.
Upon cure, affected areas are eventually replaced by scar tissue.
Affected tissue is replaced by scarring and cavities filled with caseous necrotic material.
The number of new cases each year has decreased since 2000. The latter two species are classified as "nontuberculous mycobacteria" (NTM).
Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis), the lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis), and the bones and joints (in Pott disease of the spine), among others. MTB can withstand weak disinfectants and survive in a dry state for weeks. NTM cause neither TB nor leprosy, but they do cause pulmonary diseases that resemble TB.
A definitive diagnosis of TB is made by identifying M.
tuberculosis in a clinical sample (e.g., sputum, pus, or a tissue biopsy).
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The primary site of infection in the lungs, known as the "Ghon focus", is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe.