| Popis: |
To establish the causes of bacterial excretion in complicated primary tuberculosis in children and adolescents, by comparing the data of computed tomography and the results of bacteriological studies.The material of the study was data on 36 children and adolescents with complicated primary tuberculosis, including 14 and 22 children and adolescents with and without bacterial excretion, respectively. All the children and adolescents underwent computed tomography and bacteriological studies encompassing luminescence microscopy and sputum and bronchial and gastric wash cultures for Mycobacterium tuberculosis.The bacterial excretion group showed a preponderance of a tuberculous process concurrent with the involvement of lung tissue and intrathoracic lymph nodes. Bacterial excretion was detected in the primary tuberculosis complex (50%), generalized tuberculosis process with the involvement of a few organs and systems (14.3%), and caseous pneumonia (7.1%). Bacterial excretion was accompanied by the tuberculous involvement of intrathoracic lymph nodes in 28.6%. In Group 1, sputum cultures and luminescence microscopy were carried out in all the children. At the same time, the most effective result was yielded by sputum culture that showed Mycobacterium tuberculosis in 78.6%; luminescence microscopy revealed mycobacteria in only 35.7% of cases. In 72.7% of the children and adolescents without bacterial excretion, the tuberculous process was located in the intrathoracic lymph nodes, without involving lung tissue in the pathological process. In the other 27.3%, the computed tomographic pattern of changes corresponded to that of the primary tuberculosis complex; in their presence, the tuberculous process ran with lymphogenic dissemination in 54.5% of cases and with bronchopulmonary involvement in 22.7%. In Group 2, a sputum culture was done in only 36.4% of the children and adolescents; microscopy was carried out in all.When computed tomography reveals the disseminated forms of primary tuberculosis with the concomitant involvement of lung tissue and intrathoracic lymph nodes in the presence of lung destructive changes, with the involvement of a few organs and systems in the pathological process, it is necessary to use all bacteriological studies, including culnolecular genetic methods, in order to establish the etiology of existing changes. |
