The disseminated tuberculosis

Description:

The disseminated pulmonary tuberculosis - the clinical form which is characterized by formation of multiple tuberculous focuses. Under this name it was collected several diseases, various on clinical manifestations, combined by existence on the roentgenogram of bodies of a thorax of changes symmetric in space (bilateral, approximately in similar segments, a thicket in upper parts) and in time (isomorphism, identical extent of development of process - the centers, infiltration, cavities, etc.). The situation when the cavity arose on the one hand, and the fresh centers - with another, allows to diagnose a planting phase, but not disseminated process. Dissimination at tuberculosis can occur at all stages of a course of a disease therefore in each clinical case process can carry lines of both primary, and secondary tuberculosis. Fresh primary tuberculosis, and the old centers in lymph nodes, easy or other bodies can be a source both.

Symptoms of the Disseminated tuberculosis:

Distinguish acute, subacute and chronic forms of the disseminated tuberculosis. Acute, or miliary, tuberculosis meets seldom now. Clinically conditionally allocate tifoidny, pulmonary forms and meningitis. The first on clinical symptoms reminds a typhoid. The centers in lungs come to light radiographic only on 7 — the 10th day and patients hospitalize quite often in infectious departments. Differential diagnostic characters are fever wrong, sometimes gektichesky type, the acute beginning, tachycardia, symptoms of respiratory and vascular insufficiency, existence of tubercular contact or a disease in the anamnesis. - Tuberkulinovy tests because of weight of a condition of the patient are more often negative (a negative anergy). Express serological methods of diagnosis of intestinal infection, and also character гемограмм matter: at tuberculosis the monocytosis at rather small all-inflammatory shifts is expressed, and also a lymphopenia or a lymphocytosis, and at typhus — a leukopenia.

At a pulmonary form short wind, cyanosis, dry cough prevail. The beginning is not so acute, but weight of a state gradually increases. The sharp stethalgia and dry persistent cough can sometimes be the first clinical symptoms. Radiographic in 7 — 10 days come to light multiple, same, small (to 3 mm) "prosoaidny" symmetrized in both lungs, it is preferential in upper and average parts, the centers. Degree of structure of roots and the pulmonary drawing is greased.

The reasons of the Disseminated tuberculosis:

The disseminated tuberculosis can be result of the complicated, progressing current of primary forms, but is more often observed in the secondary period of an infection On frequency among for the first time revealed, and also consisting under observation of a clinic it makes at adult 10-12%. Characteristic feature is the bacillemia in an initial phase of process and thereof symmetry of damage of lungs, productivity of inflammatory reaction in this connection on the roentgenogram comes to light mesh, and then and more rough плевропнеамосклероэ. Inflammatory changes have focal character, the centers are more often multiple, destructions rather long are not exposed, and the last is thin-walled, a thicket bilateral and also symmetric. At the disseminated tuberculosis more often than at other forms, extra pulmonary localizations, quite often the first drawing attention of the patient and doctor (pharyngalgias meet at damage of a throat, the dysuric phenomena at urinogenital defeats, etc.).

Treatment of the Disseminated tuberculosis:

Treatment has to be carried out not less than 9 — 12 months. At first (in 2 — 6 weeks) clinical symptoms disappear, and to 2 — to the 3rd month the gradual rassasyvaniye of the centers, earlier in average departments radiological is noted. The full rassasyvaniye of the centers comes in 9 — 12 months.