Principali quadri clinici della tuberolosi e loro storia naturale

The most usual manifestations and evolution of human tuberculosis are presented in this article, through the description of the most classic clinical features characterising the complex natural history of the disease. In its primary phase, parenchymal lesion, accompanying lymphangitis and satellite lymphadenitis are described, together with their complications and recovery modes. The existence of the (unfrequent) sub-primary phase and its sense are then clarified. Morphological and clinical features of the lesions, respectively miliaric or nodular or early infiltrative, characterising the early time of the post-primary phase, are then taken into special consideration, together with the particular way, for each type of such lesions, to give origin to lung cavities: these can be recognised as originating by a miliaric form (anatomical or mechanical cavity), a nodular one (biologic or colliquative form), or an early infiltrative one (post-exudative in otherwise healthy parenchyma). The more or less "perfect" recovery modes, as well as the complications, are then analysed. Finally, chronic tuberculosis and pthysis are defined and treated, together with some selected clinical features, such as tuberculomas, recidivating and migrating miliaric forms, nodular forms tending ab initio to chronicity, features peculiar of the post-primary phase evolving towards chronicity.