Приведено клиническое наблюдение успешного лечения распространенного туберкулеза легких (казеозной пневмонии) с множественной лекарственной устойчивостью у пациента с несколькими сопутствующими заболеваниями: ХО БЛ, эмфизема легких, дыхательная недоста точность I ст, гипертоническая болезнь 11ст, ишемическая болезнь сердца, кардиосклероз, токсический гепатит. Химиотерапия туберкулеза сопровождалась усиленной гепатотропной, кардиальной и мочегонной терапией калийсберегающими диуретиками. При развитии токси ческого гепатита использовались экстракорпоральные методы лечения в виде дискреторного аппаратного плазмафереза. Ключевые слова: туберкулез легких с множ ественной лекарственной устойчивостью , патогенетическая терапия, экстракорпоральны е методы, токсический гепатит.
The study materials of 23 patients with COVID-19, combined with newly diagnosed tuberculosis at the late stages of HIV infection with an average CD4+ cells count not exceeding 30 cells/μl of blood and in the absence of antiretroviral therapy (the main group) and 23 patients with no COVID-19 (the comparison group) and the similar parameters are presented. The presence or absence of COVID-19 is characterized by social maladjustment, drug addiction, concomitant viral hepatitis B or C and COPD, generalized tuberculosis with extrapulmonary damage of various organs and the development of other opportunistic pulmonary infections, similar clinical and radiological manifestations, which can only be differentiated by microbiological and molecular genetic research methods. To prevent exogenous infection of the healthy population with COVID-19, it is imperative to organize an active regular examination of all patients with tuberculosis and HIV infection for COVID-19, especially at the later stages, in the TB care office for HIV-infected people at TB dispensaries.
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