Features of pulmonary limited tuberculosis in actual epidemiological context

Abstract

Introduction. The limited forms of pulmonary TB are the clinical radiological forms that affect less than 3 pulmonary segments and these are: nodulary pulmonary TB and the limited forms of infiltrative pulmonary TB - broncho lobular infiltrate, round and oval infiltrate. Aim of the study. To assess the clinical and outcome features of pulmonary limited TB. Materials and methods. A retrospective, longitudinal, selective study, which included 48 cases of pulmonary limited TB hospitalized in the Municipal Clinical Hospital of Phthisiopneumology during 2017. Results. Limited forms of pulmonary TB are more frequently diagnosed among females 30 (62%) vs males 18 (38%), young people, aged younger 45 years old 32 (67%) vs 16 (33%) elder 45 years, and patients with urban residence 22 (46%) compared with rural ones 25 (53%). The role of the social risk factors was diminished by low life conditions in 28(58%) patients. Active smoking was identified in 26 (54%), heavy alcohol consumption was established in 8 (17%). The most of the patients 14 (29%) were detected by passive way, of which 12 (25%) cases were symptomatic. Screening of the high risk groups allowed the detection of 10 (21%) cases performed by the general practitioner and of 4 (8%) by the pulmonologist. All cases have never been treated for TB previously. Microbiological investigation revealed acid-fast-positive cases in 4 (8%) and GeneXpert in 5 (10%) cases. Epidemiological risk factors, such as TB contact and the membership of an infectious clusters were established in 8 (17%) and, accordingly, in 4 (8%) cases. The clinical-radiological diagnosis of pulmonary infiltrative was established in most cases 32(67%), with predominant localization in the upper segments S1 and S2 in 27 (56%) cases. All patients were treated using the first anti-TB drugs. Successfully treated were 40 (92%) and 4 (8%) were lost to follow-up due to improvement of the general state and lack of desire to complete the treatment. Conclusions. Most patients with pulmonary TB with limited forms encountered the social vulnerability. However, they timely contacted healthcare services, especially a general practitioner. Limited forms were localised predominantly in the upper segments, had a low indicator of microbiological positive results. Early detection of limited forms of TB has improved the outcome of the disease and can serve as a good example of an efficient casemanagement.