Clinical and Functional Characteristics of Course of Infiltrative Tuberculosis Associated with Chronic Bronchitis

O. P. Melnyk, M. M. Ostrovskyi

Abstract


Despite the tendency to certain stabilization of TB morbidity and mortality rates, the epidemical situation in Ukraine is still complex. The presence of chronic bronchitis complicates the treatment of pulmonary tuberculosis. Objective:  to improve the diagnostics of clinical-and-functional and pathogenetic disorders in patients suffering from infiltrative tuberculosis associated with chronic bronchitis. Materials and methods. This article presents the clinical features of respiratory function parameters and data fiber-optic bronchoscopy in patients with infiltrative tuberculosis combined with chronic bronchitis. The study involved 120 patients with infiltrative tuberculosis associated with chronic bronchitis. 120 patients underwent clinical examination and pulmonary function test, 59 patients were performed fiber-optic bronchoscopy. Results. Characteristic features for the development of infiltrative tuberculosis in patients with chronic bronchitis are: cough, that was observed in all 100,0% of patients, though in 80.0% of patients it was followed by expectoration which in  92.5% of patients was of mucopurulent matter; low-grade fever, general weakness, rapid fatigability, night sweats and weight loss were present in 100.0% of patients; dyspnea on regular physical activity (in 75.0% of patients); rigid vesicular breathing (in 92.5% of the examined patients), dry and at the same time sibilant and murmurous rales (in 95.0% of patients). In assessing respiratory function in conjunction phase exacerbation of chronic bronchitis and infiltrative pulmonary tuberculosis was observed while decreasing speed performance FEF25, FEF50, FEF75.  Main features for infiltrative pulmonary tuberculosis is to identify mild catarrhal inflammation in 85.7 % and 14.3 % - pronounced catarrh. Conclusions. Changes in respiratory function parameters indicate the presence of bronchial obstruction syndrome at the level of large, medium and small bronchi. Fiber-optic bronchoscopy in patients with infiltrative tuberculosis secondary to chronic bronchitis in exacerbation phase has mostly revealed florid catarrhal inflammation in 81.5% of patients and the signs of mucosal atrophy were noticed in 14.8% of the examined patients.


Keywords


infiltrative tuberculosis; chronic bronchitis; fiber-optic bronchoscopy; studies of respiratory function.

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