Features of tuberculosis’ course in fibrosing occupational interstitial lung disease

Abstract

ABSTRACT. Our own observation of the course of tuberculosis in fibrosing occupational interstitial lung disease – ILD (idiopathic fibrosing alveolitis – IFA) in a patient who was being treated at the Zaporizhzhia Regional Phthisiopulmonology Clinical Treatment and Diagnostic Center is presented. The patient had a long work experience (about 7 years) at a dangerous enterprise related to the filling and repair service of powder fire extinguishers. It is possible to determine the following features of the course of tuberculosis in fibrosing professional ILD (IFA) in the presented case: tuberculosis was diagnosed in patient with untreated IFA and progressively increasing respiratory and heart failure, which led to the progression of the tuberculosis process; tuberculosis was initially chemoresistant (RifTB) and was accompanied by fibrinous endobronchitis; dissemination on the X-ray in the lungs had the following character: small multiple foci that merge and cover the pulmonary pattern mainly next to the lungs’ roots and basal parts of the lungs. Considering the presence of a long professional route at a dangerous enterprise, increasing shortness of breath, the patient was not given a timely computed tomography of the lungs, which is the most important component of the IFA diagnosis. As a result, IFA was not diagnosed in a time, which led to the lack of necessary IFA treatment (hormonal therapy and cytostatics). A sharp progression of IFA began after the addition of chemoresistant disseminated tuberculosis. Due to this, respiratory and heart failure progressively increased, which became the direct cause of death.