[Diagnosis of tuberculosis within the general therapeutic system]

The articles contains an analysis of a dependence of the clinical-pattern nature of primarily diagnosed pulmonary tuberculosis on a tuberculosis form; on a time elapsed from the onset of primary disease signs to the requesting the medical care by a patient; and on a duration of patient's stay in a general therapeutic facility until he or she is transferred to a specialized anti-TB hospital. Medical histories of 177 patients, who were admitted to a regional anti-TB health center, were investigated. The specific pulmonary process was detected, in all patients, upon their asking for medical care within the general therapeutic network. Young patients, aged 20 to 29, were found to ask for medical assistance more often during the first days after the disease onset. Patients after 40 visited their doctors during a month and even more after the appearance of the initial disease symptoms. Pronounced clinical signs of the disease were shown to contribute to an earlier applying for medical care by patients. However, the diagnostics was impaired in pulmonology hospitals due to an intensified nature of clinical syndromes. Such syndromes, when interpreted without paying respect to peculiarities of the disease onset and without a thorough collection of anamnesis data, resulted in the wrong diagnosis. Pneumonia was diagnosed in a majority of patients, i.e. 126 cases (71.2%), in pulmonology department. A long-term stay in a non-specialized hospital and an inadequate therapy, involving large-spectrum antibiotics, aggravated the tuberculosis process. 30 from among 177 patients, who were transferred to the Regional TB health center of the Bryansk city from the general therapeutic facilities, died of the progressing specific pulmonary process.