Source: Annual Congress 2002 - Important lung infections worldwide
Disease area: Respiratory infections

Abstract

Introduction. In Russia patients with TB are treated in specialized hospitals or outpatient institutions. Primary TB diagnosis in other public health units is considered as a consequence of misdiagnosis on prehospital stage.
Aim. Lung TB diagnosis analysis in pulmonology department of emergency city hospital.
Methods. Standard diagnostic criteria were used for TB diagnosis: clinical, X-ray, positive Mantoux reaction, H37RV, sputum bacterioscopy.
Results. In 1999-2000 among total patients number (3724) TB was diagnosed in 60 patients –1.61%. 45 patients (75%) were hospitalized by ambulance, 15 – by general practitioners. In 49 cases patients were admitted with pneumonia, 6 – with COPD exacerbation, 3- with pleurisy and 3- with coronary heart disease. Infiltrative TB was diagnosed in 32 patients, fibrocavitary – in 13, disseminated – in 7, focal – in 6 and TB of intrathoracic lymphatic nodes and bronchi – in 2. In 3 patients TB was diagnosed earlier than 24 hours, in 20 – during 2-3 days, in 7 – earlier than 7 days and in 30 – later than a week.
39 patients demonstrated clinical signs and symptoms of severe pneumonia. Only in 15 patients (25% of total number) M. tuberculosis was found in sputum, 8 – demonstrated positive Mantoux reaction. In other patients TB was finally verificated only in specialized TB department.
Conclusion. The majority of cases of TB misdiagnosis take place during emergency hospitalization of patients with clinical findings of severe pneumonia.

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L. B. Sokolova, E. I. Shmelev (). TB diagnosis in Moscow emergency city hospital. Eur Respir J 2002; 20: Suppl. 38, 3802

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