More information on the Open Book is available. Copyright 2001, the National Academy Press. Keywords, machine extracted. Top 50 words repeated twice, next 100 once, plus phrases. In some however, the primary infection progresses directly and evolves into a pneumonic process as the organisms spread through the bronchi or when a tuberculous node ruptures into a bronchus.
Contiguous spread can cause infection in the pleural and pericardial spaces.
At this stage, pleurisy, which is usually abrupt and resembles bacterial pneumonia with fever, chest pain, and shortness of breath are present. Secondary tuberculosis is usually caused by organisms seeded in the apices of the lungs during the primary infection. These foci may evolve soon after seeding or after a long period of dormancy. Small patches of pneumonia develop around the foci. As the disease progresses, there is an insidious onset and development of nonspecific symptoms such as fatigue, fever, anorexia, night sweats, and general wasting.