MICROBIOLOGICAL TESTS
bacterioscopic method (microscopysputum by Zyll-Nielsen, fluorescentmicroscopy), cultural method (cultureon Lowenstein- Jensen and Finn-2 media,"Nova, A-6, A-9, etc.) - after 33 days appearance of MBT growth.
GROWTH INTENSITY:
1.(+) - 1 to 20 CFU in vitro (scantybacterial isolation);
2.(++) - 20-100 CFU in vitro (moderate bacterial(moderate bacterial isolation); 2;
3.(+++) - >100 CFU in a test tube (abundant(+++) - >100 CFU in a test tube (abundant bacterial isolation).
There are automated systems: MGIT-BACTEC - 960 and MB/Bact. - 11 - 19 days appearance of MBT growth.
4. INSTRUMENTAL METHODS
RESEARCH
1. CURRENT DIAGNOSTICS METHODS:
digital fluorography, tomography, CT scan, radionuclide methods (scintigraphy), ultrasound examinations (USG).
2. BRONCHOLOGICAL DIAGNOSTIC METHODS: Bronchoscopy (diagnostic and therapeutic).
3. EXTERNAL RESPIRATORY FUNCTION TEST:
spirometry (including pneumotachymetry); evaluation carbon monoxide (II) diffusing capacity of lungs- DLCO; total body plethysmography(bodiplethysmography); total lung capacity (TLC);pulmonary distensibility study (marginal pressure- volume) by nutritional sounding.
4. 6-MINUTE WALKING TEST - assessment of patient's functional capacity, especially in the presence of severe and moderate degrees of severityheart and lung pathology
5.SURGICAL METHODS ISSUES
1.NEEDLE METHODS OF INVESTIGATION: - puncture of the pleural cavity;
- transthoracic needle biopsy.
2.OPEN DIAGNOSTIC OPERATIONS:
-biopsy of peripheral lymph nodesnodes;
-- open lung biopsy.
3. ENDOSURGICAL OPERATIONS:
-Thoracoscopy (pleurovoidoscopy);
-- mediastinoscopy.
TB DETECTION IN CHILDREN AND
ADOLESCENTS
A characteristic feature of TB in children is involvement in the pathological process of the entire lymphatic system, mainly intrathoracic lymph nodes, and slow evolution of specific changes in them.
Localization of the pathogen in the lymphatic system is one of the reasons limiting the possibility bacteriological confirmation of the diagnosis (at least 90% of children and 50% of adolescents with newly diagnosed tuberculosis of the lungs and intrathoracic lymph nodes are not are not bacteriologically isolated).
STAGES OF DEVELOPMENT
TUBERCULOSIS TUBERCLE
1.Non specific circulation,characterized by the development of granulomas histiocyte-macrophage (the first 1-5 months).
2.Paraspecific inflammation. Granulomas form in various organ tissues, stimulating pathology of their side.
3.Specific inflammation. Forms pathognomonic tuberculous granuloma. Part of the alveolar MF dies, detritus is formed. On the border of alveolar MF and lung tissue – a leukocytic swath.
Tubercular tubercles form tubercular foci
The fate of tuberculous tubercles can vary:
-Resorption,
-Organization,
-Fusion → Infiltrate, Decay →Formation of an acute cavern.
INITIAL DTL FOCI, ×100.
а. Encapsulated caseous focus in the lungs in the initial stage of endogenous reactivation.
b. Endogenous reactivation of the caseous focus.
THERE ARE THREE MAIN FORMS OFOF PRIMARY TUBERCULOSIS:
TUBERCULSION INTOXICATION (dolocal): Clinically, a distinction is made between: -early;
-late.
TUBERCULOSIS intrathoracic lymph nodes (local): -Small;
-infiltrative; -tumorose.
FIRST TUBERCULES OF TUBERCULES COMPLEX (local).
MANIFESTATIONS OF
TUBERCULOSIS INTOXICATION:
1.«Virage».
2.Micropolyadenopathy.
3.Predominant intoxication syndrome.
4.Radiologically – normal pulmonary pattern.
Differential diagnosis conducts:
1.With chronic nonspecificinfection.
2.With worm infestation.
3.With vegetative vascular dystonia.
4.With mental illness.
5.With oncology.