DIAGNOSTIC ALGORITHM OF TUBERCULOSIS COMBINED WITH CHRONIC BRONCHITIS AND ANTIMICOBACTERIAL THERAPY
DOI:
https://doi.org/10.32782/2786-9067-2023-25-7Keywords:
pulmonary tuberculosis, destruction, bacterial excretion, chronic bronchitis, verification of endobronchitis, chemotherapy.Abstract
Abstract. In modern conditions, the clinical course of pulmonary tuberculosis is often manifested by the development of a specific process against the background of chronic bronchitis, which is characterized by the manifestation of symptoms of both diseases, complicating the timely diagnosis of tuberculosis, in connection with which the problem of the relationship between these two diseases requires in-depth study. The work presents the development of criteria for the clinical-instrumental and laboratory algorithm for the diagnosis of pulmonary tuberculosis in combination with chronic bronchitis. 300 patients with destructive pulmonary tuberculosis aged 15-67 were examined: in 93 (31,0 %) tuberculosis was combined with chronic bronchitis, in 207 (69,0 %) - only pulmonary tuberculosis. Clinical, laboratory and instrumental methods were used for the examination. In 31,0 % of patients, a high specific gravity of chronic bronchitis, which occurred before the development of specific inflammation, was established. An acute onset with the presence of a productive cough was noted in 26 (27,9 %) patients, increased ESR - in 49 (52,6 %) and leukocytosis - in 29 (32,0 %), this was much more often expressed in patients with mixed pathologies. In the same patients, a longer period of healing of the destructive process was observed. Antimycobacterial therapy showed a high therapeutic effect in patients with tuberculosis in combination with chronic bronchitis: cessation of bacterial excretion was observed in 85 (96,6 %) and healing of destruction - in 76 (81,7 %) patients, which was slightly inferior to the results of treatment of patients who suffered not only from pulmonary tuberculosis. Two variants of endobronchitis have been established: non-specific diffuse inflammation of the bronchi as a result of chronic bronchitis, and so-called reactive "paraspecific" endobronchitis as a result of the toxic-allergic effect of the tuberculosis process.
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