АКТУАЛЬНЫЕ ПРОБЛЕМЫ ТУБЕРКУЛЕЗА У ПОДРОСТКОВ ИЗ ОЧАГОВ ТУБЕРКУЛЕЗНОЙ ИНФЕКЦИИ

The article characterizes respiratory tuberculosis in adolescents exposed to tuberculous infection. Exposure to tuberculosis in the family or when contacting close relatives makes the biggest contribution into development of the disease unless the patient is isolated from those exposed. Advanced and severe forms of tuberculosis with bacillary excretion are detected, compromising the life quality of adolescents. The main causes of late diagnostics are poor performance of TB services, primary medical units, low level of health education aimed at the increase of motivation to have planned medical examinations in the general population and to take relevant sanitary and hygienic measures in the sites of infection. Adolescents from the sites with bacillary excretion, and, first of all, if multiple or extensive drug resistant tuberculosis is detected, are to be considered a high priority group facing the risk to develop the disease with more frequent monitoring and deeper examination. In primary medical units, should any sings typical of tuberculosis be presented, it is sensible to add skin tests (Mantoux test and test with tuberculous recombinant allergen) to the minimum diagnostic procedures. Organizational, methodical and health education activities in the sites of infection are to be improved.Дана характеристика туберкулеза органов дыхания у подростков из контакта с больным туберкулезом. Набольшее значение для развития заболевания имеет контакт в семье и с близкими родственниками без изоляции контактирующих лиц от больного. Выявляются тяжелые, распространенные процессы с бактериовыделением, которые снижают качество жизни заболевшего подростка. Основные причины поздней диагностики – недостатки в работе противотуберкулезной службы, первичной медико-санитарной помощи (ПМСП), низкий уровень санитарно-просветительной работы по повышению мотивации населения к плановым обследованиям и соблюдению санитарно-гигиенических мероприятий в очаге. Подростки из очагов с бактериовыделением, в первую очередь при обнаружении микобактерий туберкулеза с множественной/широкой лекарственной устойчивостью, должны рассматриваться как приоритетная группа риска развития заболевания с более частым мониторингом, углубленным обследованием. В учреждениях ПМСП при наличии клинических признаков, таких же как при туберкулезе, целесообразно включить в диагностический минимум кожные иммунологические тесты (проба Манту и проба с аллергеном туберкулезным рекомбинантным). Необходимо совершенствование работы организационно-методической и санитарно-просветительной работы в очагах

Клапанная бронхоблокация в комплексном лечении туберкулеза органов дыхания у подростка

Goal: The clinical case is presented to describe the successful use of valve bronchial block (installation endobronchial valve into the bronchus) for treatment of cavities in the 15 year old female adolescent with bilateral pulmonary tuberculosis.Results. The X-ray examination showed the healing of cavities in 3 months after installation of endobronchial valve. The endobronchial valve stayed in the upper zone left bronchus for 6 months and it was successfully removed through bronchoscopy upon the treatment completion. Цель. Представлено клиническое наблюдение успешного применения метода клапанной бронхоблокации (установка в бронх эндобронхиального клапана) для лечения каверн у девочки-подростка 15 лет с двусторонним туберкулезом легких.Результаты. Закрытие полостей распада зафиксировано рентгенологически через 3 мес. после установки эндобронхиального клапана. Эндобронхиальный клапан находился 6 мес. в верхнезональном бронхе слева и был успешно извлечен при бронхоскопии после окончания лечения

Reasons for late diagnostics of tuberculosis in adolescents

In total the authors reviewed 83 patient records: disease development anamnesis, results of the standard clinical, radiological and laboratory examinations.  Tuberculosis in adolescents  found during routine examination is characterized by a high epidemic risk (45% of patients were sputum positive), severe clinical forms of the disease with the pronounced residual abnormalities and therefore need of surgical treatments. Patients with the clinical signs of pulmonary disease (pneumonia, bronchitis, recurrent acute respiratory infections) belong to the risk group requiring evaluation for tuberculosis including with the use of immunological skin tests

Valve bronchial block in the integrated treatment of respiratory tuberculosis in the adolescent

Goal: The clinical case is presented to describe the successful use of valve bronchial block (installation endobronchial valve into the bronchus) for treatment of cavities in the 15 year old female adolescent with bilateral pulmonary tuberculosis.Results. The X-ray examination showed the healing of cavities in 3 months after installation of endobronchial valve. The endobronchial valve stayed in the upper zone left bronchus for 6 months and it was successfully removed through bronchoscopy upon the treatment completion

ACTUAL ISSUES OF TUBERCULOSIS IN ADOLESCENTS EXPOSED TO TUBERCULOSIS INFECTION

The article characterizes respiratory tuberculosis in adolescents exposed to tuberculous infection. Exposure to tuberculosis in the family or when contacting close relatives makes the biggest contribution into development of the disease unless the patient is isolated from those exposed. Advanced and severe forms of tuberculosis with bacillary excretion are detected, compromising the life quality of adolescents. The main causes of late diagnostics are poor performance of TB services, primary medical units, low level of health education aimed at the increase of motivation to have planned medical examinations in the general population and to take relevant sanitary and hygienic measures in the sites of infection. Adolescents from the sites with bacillary excretion, and, first of all, if multiple or extensive drug resistant tuberculosis is detected, are to be considered a high priority group facing the risk to develop the disease with more frequent monitoring and deeper examination. In primary medical units, should any sings typical of tuberculosis be presented, it is sensible to add skin tests (Mantoux test and test with tuberculous recombinant allergen) to the minimum diagnostic procedures. Organizational, methodical and health education activities in the sites of infection are to be improved