[Diagnosis and treatment of acute progressive tuberculosis types]

An examination was made of 77 patients with extensive segmentary and lobular pulmonary tuberculous lesions: caseous pneumonia (n = 26), infiltrative caseous pneumonia (n = 18), fibrocavernous pneumonia complicated by caseous pneumonia (n = 16), and disseminated tuberculosis (n = 17). All patients had destructive changes; in 82.7% of patients the caverns were large and great in size. Bacteria were isolated in 94.8%, mycobacterial drug resistance was noted in 51.8%. Four variants of the course of a disease were identified: 1) that with predominance of the intoxication syndrome (41.6%); 2) that with respiratory failure (24.7%); 3) that with pulmonary hemorrhage (15.6%), 4) that added by secondary microorganisms (18.2%). Chemotherapy included a combination of 4 or 5 drugs along with pathogenetic tools, which stabilized a process in 80% of patients and arrested bacterial isolation in 69.5%. In 20%, the process continued to progress and in 3 of them died.