How is caseum evolution?

The debridement of the caseum : ✔ Internal debridement by macrophages is ineffective in removing the caseum. ✔ External debridement is possible :complex process, begins with the softening of the caseum: it becomes of liquid consistency, the polynuclear flowing into it t, The BK multiply very actively.The softened caseum is then removed in different ways depending on the location of the lesion. ✔ If the lesion is pulmonary the caseous focus can open to a bronchus ✔ A cavity then persists after the evacuation of the caseum ✔If the lesion is located under the skin or under a mucous membrane, the caseum is evacuated through an ulceration of the epithelium (ex: ulceration of intestinal tuberculosis) ✔In the absence of external debridement, a fluctuating swelling occurs, clinically analogous to an abscess, but without pain or fever (cold abscess). ✔Calcification of the caseum The case which has not softened persists indefinitely in the body undergoing slow physico-chemical changes that lead to its calcification ✔This phenomenon is accompanied by a gradual decrease in the number of BK that persist in necrosis