microbiological diagnostics of a tuberculosis at children, sick HIV-infections

For revealing and an establishment of the diagnosis of a tuberculosis etiological diagnostics - a finding of micobacteria of a tuberculosis in ljuyobom a biological material is very important. Besides, for successful treatment tuberkuyoleza it is very important to make a combination of antituberculous preparations to which sensitivity of micobacteria of a tuberculosis (MBT) is kept.

Unfortunately, at children bakteriovydelenie owing to features primary tuyoberkuleza (lymph nodes are amazed) happens seldom and does not exceed 5 % [1,124].

Before (tab. 4.5) we cited data on frequency of allocation MBT at sick of an intrathoracic tuberculosis with primary forms. In 1 group of a micobacterium have been found out at 25 (15,5 %), in 2 group - at 10 (10,5 %) and in 3 group - at 6 (8,4 %) patients.

More often bakteriovydelenie it was observed at intrathoracic lymph nodes sick of a tuberculosis (table 4.22) that can indirectly testify to a lesion of bronchuses (a tuberculosis of bronchuses, formation bronho-noduljarnyh fistulas) which are not diagnosed because of absence traheobronhoskopicheskih researches.

Table 4.22

Bakteriovydelenie at sick of an intrathoracic tuberculosis with primary forms in research groups

The tuberculosis form MBT (+)
1 group (п=161) 2 group (п=95) 3 group (п=71)
TVGLU 11 (44,0 %) 6 (60,0) 3 (50,0)
PTK 6 (24,0 %) 4 (40,0) 2 (33,3)
disseminirovannyj (generalised) 8 (32,0 %) - 1 (16,7)
In total 25 (100 %) 10 (100 %) 6 (100)

At children in third of cases the finding of micobacteria has been bound to a HIV-infection with disseminirovannymi processes though a source vydeleyonija MBT, most likely, were intrathoracic lymph nodes, priyovodjashchie to a lesion of bronchuses.

It is difficult to take away a sputum from children of thoracal age for research on MBT, therefore a material was having washed off with a nasopharynx, washout from bronchuses, seldom washing waters of a stomach (at 2 patients). In two children of a micobacterium have been found out in urine.

Taped MBT less often a method of luminescent microscopy - at 20 of 41 (48,8 %) and a little bit more often - kulturalnym a method - at 21 of 41 children (51,2 %). Medicinal fastness (LU) the originator to protivotuberkuyoleznym to preparations is taped at 10 (40 %) children of 1 group: at three - mnozhestyovennaja medicinal fastness (MLU), at one child - wide leyokarstvennaja fastness (SHLU), at other six children LU zaregistyorirovana to Isoniazidum (), to streptomycin (S) or to Kanamycinum () and them soyochetaniju (N S, S). At children of 2 groups LU it is established in 4 cases (40 %): at three - MLU and at two - to N S. At patients of 3 groups LU it has been taped at 2 children (33,3 %), in all two cases it was defined MLU.

In etiological diagnostics identification of micobacteria is very important. At 3 children with a micobacterium HIV-infection identifitsirovayony as not tubercular micobacteria (NTMB), that demanded treatment correction.

The tuberculosis of peripheric lymph nodes has been confirmed by histological research bioptata, and in the presence of a fistula - research on MBT in separated.

The resume

More serious current of tubercular process at children with a HIV - an infection can be bound to late revealing at them disease. More than in half of cases (53,0 %) a tuberculosis at children with a HIV-infection

133 it was taped under complaints (on appealability) unlike children without an infection HIV - (22,6 % - in 2 group and 25,6 % - in 3 group; r

<< | >>
Scientific source KLEVNO HOPE IVANOVNA. TUBERCULOSIS At CHILDREN, SICK HIV-INFECTIONS (prevalence, features of clinical implications, diagnostics, treatment, preventive maintenance). The dissertation on competition of a scientific degree of the doctor of medical sciences. Moscow - 2015. 2015

Скачать оригинал источника

Other medical related information microbiological diagnostics of a tuberculosis at children, sick HIV-infections:

  2. microbiological diagnostics of a tuberculosis at children, sick HIV-infections