A Comparison of Clinical and Radiographic Signs of Nontuberculous Mycobacterial Pulmonary Disease, Destructive Drug-Resistant Pulmonary Tuberculosis and a Combination of Nontuberculous Mycobacterium Pulmonary Disease and Pulmonary Tuberculosis

Author:

Giller Dmitrii1,Scherbakova Galina1,Enilenis Inga1,Martel Ivan1,Kesaev Oleg1,Koroev Vadim1,Popova Anna1,Ilyukhin Alexandr1,Basangova Valeria1,Smerdin Sergey2,Mayusupov Shokirjon3,Saenko Sergey4ORCID,Frolova Olga15,Vinarskaya Veronika1,Severova Lyudmila1ORCID

Affiliation:

1. Department of Phthisiopulmonology and Thoracic Surgery Named after M.I. Perelman, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia

2. State Budgetary Healthcare Institution of the Moscow Region “Moscow Regional Clinical Anti-Tuberculosis Dispensary”, Sukmanikha Village, Shchelkovsky District, Moscow 170555, Russia

3. Republican Specialized Scientific-Practical Medical Center for Phthisiology and Pulmonology, St. Majlisy, Shaykhotokhur District, Tashkent 100071, Uzbekistan

4. Rostov Regional Clinical Center of Phthisiopulmonology, St. Orskaya, 24, Rostov-on-Don 344065, Russia

5. Department of Phthisiopulmonology, Pirogov Russian National Research Medical University, Moscow 117997, Russia

Abstract

A misdiagnosis of isolated pulmonary tuberculosis (pTB) is highly likely when a patient has nontuberculous mycobacterial pulmonary disease (NTMPD) or a combination of nontuberculous mycobacterium pulmonary disease and pulmonary tuberculosis. Frequently, bacterial excretion is absent or only Mycobacteria tuberculosis (MBT) is found. This often results in an incorrect diagnosis and subsequent misinformed treatment regimes. In order to determine possible clinical and radiographic differences between patients with NTMPD (Group 1), destructive drug-resistant pulmonary tuberculosis (Group 3) and a combination of NTMPD and pTB (Group 2) we compare clinical and radiographic signs for these three patient groups. When comparing with Group 3 (2.5%), Groups 1 (25%) and 2 (17.4%) have a substantially higher incidence of pulmonary haemorrhages. Thus, upon clinically observing the combination of pTB and NTMPD, there are no pathognomonic clinical and radiographic detected symptoms. However, the presence of an indolent course, hemoptysis and bronchiectasis in the presence of acid-fast bacteria (or identified MBT) in the sputum makes it possible to suspect not simple pTB, but a combination of pTB and NTMPD. To clarify this necessitated in-depth bacteriological examination.

Publisher

MDPI AG

Subject

Infectious Diseases,Microbiology (medical),General Immunology and Microbiology,Molecular Biology,Immunology and Allergy

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