Introduction. Currently, there has been an improvement in the situation of tuberculosis in the Russian Federation. Despite successful preventive and diagnostic measures of phthisiatric service, cases of the disease still occur in adolescence. Purpose of work. Clinical demonstration of a case of pulmonary tuberculosis in an adolescent with concomitant pathology. Methods. A clinical case of a 16-year-old boy with infiltrative pulmonary tuberculosis, which developed against the background of a longstanding infection with MBT, presented. The rapid development of pronounced changes in the lungs, decay and infiltration may have been provoked by adolescent age and the presence of concomitant pathology. Results. Slow clinical and radiological dynamics observed in the course of the disease, but the complex approach to treatment with the use of minimally invasive non-medicinal method of valve bronchoblockage permitted to achieve positive results. Due to their physiological peculiarities, connected with hormonal reorganization of the body, teenagers are a «risk group» for tuberculosis. Discussion and Conclusion. Tuberculosis process in this age group is characterized by a number of distinctive features which are related to certain reasons, among which are anatomical and physiological peculiarities of teenagers, changes in living conditions, transition from complete social and economic dependence on adults to relative social independence and coexisting diseases. The task of general practitioners and tuberculosis doctors is to organize the early detection of tuberculosis in adolescence and to provide correct and controlled treatment.

One of the significant problems in pediatrics remains tuberculosis in children and adolescents. Particular attention in the verification of the radiological syndrome, as a “rounded” shadow, is given to tuberculosis. This is not always justified. Echinococcosis is a parasitic disease of cyclic nature, affecting vital organs, including the lungs. One of the radiological manifestations of echinococcosis in the lungs is a rounded shadow syndrome, which requires a multidisciplinary approach to diagnosis.

The identification of millions of newly infected with tuberculosis while maintaining a sufficiently high mortality rate, despite the existing treatment protocols, confirms the urgency of the problem of diagnosing this disease and dictates the need for an interdisciplinary approach to this problem. In the overwhelming majority of cases, tuberculosis is associated with lung damage, but its “extrapulmonary” manifestations are also possible, in particular with localization in the head and neck region (about 10%), including in the ENT organs. According to the literature, the incidence of tuberculous lesions is maximum for the larynx (from 14,5 to 15–37%), minimum for ear diseases (from 0,04–0.09% to 2,4–4,18%). To focus the attention of otorhinolaryngologists on the problem of “extrapulmonary tuberculosis” of ENT localization in pediatric practice, this study analyzes the case histories of 496 patients of tuberculous pulmonary pediatric department No. 1 of the Moscow Research and Clinical Center for Tuberculosis Control. Tuberculous lesion of ENT localization against the background of a generalized process was found in 7 patients (1.4%) aged from 2,5 months to 1 year 9 months. Tuberculous otitis media was most often detected (4 patients (0.6%)), in single cases – tuberculosis of the larynx, tuberculosis of the pharynx, tuberculosis of the salivary gland, including in combination with other organic ENT pathology (for example, papillomatosis and tuberculosis of the larynx). Thus, the lesion of the head and neck (including the ENT organs) is one of the “underestimated” extrapulmonary localizations of tuberculosis, and the diagnosis and verification are delayed. Among the “extrapulmonary” ENT manifestations of tuberculosis in young children, according to our data, otitis media prevails. To verify the diagnosis of “Tuberculosis” of any localization, it is necessary to inoculate Mycobacterium tuberculosis and be sure to consult the material obtained with histologists. Doctors of various specialties should not forget about the possibility of setting Mantoux tests with 2 tuberculin units (TU) and adenosine triphosphate (ATP) test for diagnostic purposes, despite the absence of a routine immunological examination in the national immunization schedule for children of the first year of life. Tuberculosis is curable, the main thing is to remember the need for early and timely diagnosis and adequate long-term treatment.

The topicality of this work consists in the fact that even at the present time one of the significant problems in pediatrics remains tuberculosis in infancy and toddlerhood. And today, in spite of successful preventive work at all levels, the proportion of young children in the structure of tuberculosis in children and adolescents prevails. Such patients require a special approach to treatment and prevention of the disease. Timely diagnosis often leads to a quick and complete cure.