The characteristics of the patients with disseminated pulmonary tuberculosis and drug resistance

Abstract

Background. Disseminated tuberculosis is a life-threatening disease resulting from the hematogenous spread of Mycobacterium tuberculosis. The aim. Study of the predisposing factors and peculiarities of the clinical evolution of resistant disseminated pulmonary TB. Subjects and methods. In 2021-2022 in Municipal Clinical Hospital Phthisiopneumology, Chisinau were treated 65 patients with disseminated pulmonary tuberculosis, new cases, and retreatment cases. Results. Disseminated pulmonary TB more frequently was developed in men (55 (84.6%) cases). Male/ female ratio being 5.5: 1. The predominant age was 20-40 years – 39 (60.0%) cases. The main TB detection pathway was active - 64 (98.5%) patients. The majority (66.2%) of the persons were not employed. In contact with TB patients had 28 (43.1%) cases, 11 (39.3%) people were from death outbreaks and 8 (28.7%) relative contacts. Several patients 33 (50.8%) were detected in the range of 3 to 6 months from the appearance of the first clinical manifestations. Acute disseminated TB were in 14(21,5%) cases, subacute – 34(52,3%), chronic – 17 (26,2%). The majority of patients were with positive sputum smear - 52 (80.0%), which was confirmed by the bacteriological method - 61 (93.9%) cases. In 21 (32.3%) patients, resistance to MBT against antituberculosis drugs was found. Conversion of sputum in 23 (35.4%) patients were obtained at the 3rd month of specific treatment. Negative results of treatment predominated, with a high rate of deaths - 27 (41.6%) cases. Conclusions. Diagnosis is difficult owing to its nonspecific clinical picture and the limited tools for confirmatory laboratory diagnosis. Improved awareness of this disorder and associated trends might improve a clinician’s index of suspicion and lead to a better diagnostic approach.