Caseous Necrosis
Caseous necrosis is a type of tissue cell death known for its appearance resembling cheese, resulting in a crumbly, white texture of the affected tissue.
Development of Caseous Necrosis
Caseous necrosis typically occurs as a response to various infections in the body, where the immune system reacts by causing tissue death. Bacterial or fungal infections commonly lead to this form of necrosis.
Other Types of Necrosis
Coagulative necrosis: Caused by reduced blood supply, affecting cells throughout the body except the brain, where cell structure remains intact until cleared by the body’s defenses.
Fat necrosis: Characterized by chalky white deposits, often seen in conditions like pancreatitis or trauma in breast tissue.
Fibrinoid necrosis: Occurs in blood vessel linings, resulting in lesions that can cause bruising and bleeding.
Liquefactive necrosis: Cells lose structure and liquefy, producing pus in bacterial infections, commonly found in the brain and spinal cord.
Causes of Caseous Necrosis
The primary cause of caseous necrosis is tuberculosis (TB), a bacterial lung disease that can spread to other parts of the body. TB can be latent (dormant) or active, with symptoms varying from chest pain and persistent cough to fever, night sweats, and weight loss. Infants, young children, and individuals with weakened immune systems are particularly vulnerable to active TB.
Other diseases that may lead to caseous necrosis include histoplasmosis and syphilis.
Symptoms of Caseous Necrosis
Symptoms primarily depend on the underlying disease. For active pulmonary TB, symptoms include chest pain, prolonged cough, coughing up blood, fatigue, fever, night sweats, and weight loss.
Diagnosis of Caseous Necrosis
Pathologists diagnose caseous necrosis by examining tissue samples under a microscope (biopsy). Biopsies are invasive but necessary when less invasive methods fail to diagnose the condition. TB is diagnosed through chest X-rays, sputum testing, and modern molecular tests detecting DNA in sputum samples.
Management and Treatment
Treatment focuses on addressing the underlying conditions causing caseous necrosis. TB treatment involves a multi-month regimen with multiple medications, tailored to the patient’s needs and potential antibiotic resistance. Healthcare providers assist patients in managing medication side effects.
Prevention
Preventing TB involves minimizing exposure, especially in high-prevalence regions like India, China, and Indonesia. Precautions in clinics, hospitals, and homeless shelters are crucial. Screening and early treatment of latent TB infection can prevent active TB development.
Prognosis
Effective TB treatment usually leads to positive outcomes for patients. Without treatment, approximately half of TB-infected individuals may face serious complications.
When to Seek Medical Attention
If exposed to TB, it’s essential to consult healthcare providers promptly for screening and necessary preventive measures.