[Laboratory diagnostic methods in primary pulmonary tuberculosis in adults]

Area of Science:

• Pulmonology
• Infectious Diseases
• Clinical Immunology

Background:

• Primary tuberculosis in adults presents diverse clinical patterns, including intrathoracic lymph node involvement, infiltrative lung disease, and pleurisy.
• Diagnosis of primary tuberculosis in adults is challenging, with conventional methods often insufficient.

Purpose of the Study:

• To evaluate the clinical and roentgenological characteristics of primary tuberculosis in adults.
• To assess the diagnostic utility of sputum examination for altered forms of Mycobacterium tuberculosis (MBT).
• To investigate the role of immune system and metabolic disorders in adult primary tuberculosis and improve diagnostic accuracy using immunologic and biochemical assays.

Main Methods:

• Comprehensive clinical and roentgenological evaluation of 495 adult patients with primary tuberculosis.
• Sputum analysis for altered forms of Mycobacterium tuberculosis (MBT).
• Assessment of T- and B-lymphocyte systems, immune defense, and metabolic processes.
• Application of immunologic and biochemical studies for diagnostic enhancement.

Main Results:

• Primary tuberculosis was diagnosed in 56.4% of adult patients.
• Sputum examination for altered MBT forms increased diagnostic verification by 16.0%.
• Primary tuberculosis in 63.5% of adults occurred with significant immune and metabolic dysfunctions.
• Immunologic studies improved primary tuberculosis diagnosis accuracy from 56.4% to 79.6%.
• Biochemical studies improved diagnostic accuracy from 56.4% to 77.5%.

Conclusions:

• Adult primary tuberculosis commonly manifests as intrathoracic lymph node disease, infiltrative lung lesions, or exudative pleurisy.
• Enhanced diagnostic approaches, including sputum analysis for altered MBT forms and immunologic/biochemical testing, are crucial for accurate adult primary tuberculosis diagnosis.