Extrapulmonary tuberculosis: diagnostic features

M. A. Yudenko, I. Buinevich, D. Y. Rusanau
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Abstract

Objective. To study demographic, clinical characteristics and concomitant pathology of patients with extrapulmonary tuberculosis (EPTB) in Gomel city and Gomel region for the period 2017-2021. To evaluate the informative value of different techniques for the detection of Mycobacterium tuberculosis (MBT) in non-respiratory samples in the diagnosis of extrapulmonary tuberculosis.Materials and methods. A retrospective study of extrapulmonary tuberculosis cases registered from 2017 to 2021 in Gomel and Gomel region (308 patients) was carried out. The results of microscopic, bacteriological and molecular genetic methods of non-respiratory and respiratory samples relevant in the diagnosis of extrapulmonary forms of tuberculosis were analyzed.Results. Demographic and clinical characteristics of patients with EPTB in Gomel and Gomel region for the period 20172021 were revealed. Concomitant pathology in patients with EPTB was analyzed, the features of EPTB diagnostics were studied. It was determined that EPTB is more susceptible to males aged 31 to 50 years and to women aged over 60 years. EPTB is more frequently diagnosed in patients from urban areas and when patients come to medical institutions with nonspecific complaints, except for intrathoracic lymph node tuberculosis (ITLN).Conclusion. In the structure of clinical forms of EPTB, lesions of bones and joints (62.7%) and intrathoracic lymph nodes (19.5%) predominate. HIV-positive patients are more common in the ITLN group. MBT is most often detected in the following localizations of extrapulmonary process: intrathoracic and peripheral lymph nodes, pleural tuberculosis. The most highly informative method of examination of biological nonrespiratory material for detection of MBT in extrapulmonary localization is molecular genetic study.
肺外结核:诊断特征
目标。研究2017-2021年戈梅利市和戈梅利地区肺外结核(EPTB)患者的人口学、临床特征和伴随病理。目的评价不同方法检测非呼吸道标本结核分枝杆菌(MBT)在肺外结核诊断中的信息价值。材料和方法。回顾性研究2017 - 2021年戈梅利和戈梅利地区登记的肺外结核病例(308例)。本文对非呼吸和呼吸标本的显微、细菌学和分子遗传学方法在肺外结核诊断中的作用进行了分析。揭示了2017 - 2021年戈梅利和戈梅利地区EPTB患者的人口统计学和临床特征。分析了EPTB患者的伴随病理,探讨了EPTB的诊断特点。结果表明,31岁至50岁的男性和60岁以上的女性更易感染EPTB。除了胸内淋巴结结核(ITLN)外,EPTB在城市地区和非特异性主诉就诊的患者中更常见。EPTB临床形态结构以骨骼和关节病变(62.7%)和胸内淋巴结病变(19.5%)为主。hiv阳性患者在ITLN组中更为常见。MBT最常见于肺外过程的以下部位:胸内和周围淋巴结,胸膜结核。在肺外定位中,检测MBT的生物非呼吸物质最具信息量的方法是分子遗传学研究。
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