DIFFICULTIES OF TUBERCULOSIS DETECTION BY A LOCAL PHISICIAN IN THE PERIOD OF THE EPIDEMIC OF INFLUENZA (CLINICAL CASE)

E A Borodulina,A T Inkova,P M Zelter,E V Borodulina,T N Matkina

doi:10.22625/2072-6732-2018-10-3-151-156

E A Borodulina, A T Inkova + Show 3 more

Open Access

https://doi.org/10.22625/2072-6732-2018-10-3-151-156

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Abstract

Purposeof issue is to show difficulties of detecting tuberculosis the general physician during epidemic of acute respiratory viral infection and flu, to show efficiency of modern methods of mycobacterial and HIV evaluation.Materials and methods. Clinical case from general physician’s practice was discussed. All methods from primary healthcare were used.Results. Possibilities of tuberculosis diagnostics by general physician during epidemic were shown. Tuberculosis was held under mask of flu. While carrying out diagnostic minimum negative results have been received. As a result of plane radiography dissemination was found. After analysis of social risk factors, analysis for HIV and «Diaskin-test» were made. Sputum also was sent for mycobacterium evaluation to antituberculosis center laboratory. Positive «Diaskintest» (8 mm), positive Gene-expert molecular-genetic test and BACTEC fluid growth were found. Diagnosis of tuberculosis was stated and patient was sent to specialized center.Conclusion. During flu epidemic alertness of general practitioners about tuberculosis is needed especially in social risk groups. It is recommended to enlarge diagnostic minimum using molecular genetic methods. These actions can improve rate of tuberculosis proving.

Highlights

Purpose of issue is to show difficulties of detecting tuberculosis the general physician during epidemic of acute respiratory viral infection and flu, to show efficiency of modern methods of mycobacterial and HIV evaluation
У больных ВИЧ-инфекцией туберкулез может развиться как в результате активации имеющейся латентной туберкулезной инфекции, так и в результате влияния ВИЧ на иммунный статус пациента и повышения чувствительности к микобактерии туберкулеза [14, 15]
Наркомания, ВИЧ часто распространяются в среде с плохими жилищными условиям, бедностью, плохим питанием, безработицей и другими факторами риска, которые являются факторами риска и для развития туберкулеза [16,17,18]

Summary

Introduction

Purpose of issue is to show difficulties of detecting tuberculosis the general physician during epidemic of acute respiratory viral infection and flu, to show efficiency of modern methods of mycobacterial and HIV evaluation. Туберкулез легких чаще выявляется в осеннезимний сезон, в период роста бронхо-легочных заболеваний и сезонных эпидемий гриппа. Представлен клинический случай выявления туберкулеза легких в сочетании с ВИЧ-инфекцией в практике участкового терапевта в период острых респираторных инфекций и эпидемии гриппа.

Results

Conclusion