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  • Title: [Diagnosis, clinical picture and treatment policy in acute progressive forms of pulmonary tuberculosis under present-day epidemiological conditions].
    Author: Khomenko AG, Mishin VIu, Chukanov VI, Korneev AA, Voronina GA, Vasil'eva IA.
    Journal: Probl Tuberk; 1999; (1):22-7. PubMed ID: 10199178.
    Abstract:
    Among 103 examinees, the most common clinical type was caseous pneumonia (45.6%), progressive fibrocavernous tuberculosis (20.4%), infiltrative caseous pneumonia (17.5%), disseminated tuberculosis (16.5%). Progression was characterized by cavern formation in 91.1% of patients, with large and giant caverns containing nonspecific microbes forming in 79.6%. All the patients were found to isolate bacteria and 93.5% showed their excess. Drug-resistant microbes were identified in 62.1% of patients; polydrug resistance was seen in 37.5%. Chemotherapy was performed at the first stage by using 5 drugs: isoniazid, rifampicin, pyrazinamide, ethambutol plus kanamycin or amikacin. A combination of reserve drugs, including prothionamide, ofloxacin (ciprofloxacin) amikacin, pyrazinamide, and ethambutol, was used in patients with polyresistance. Symptomatic and pathogenetic therapies should aim at correcting complications and concomitant abnormalities. Following 6 months, 80% of patients stopped isolating bacteria, the process became stable and they could be prepared for planned surgical treatment. In 20% of cases, the process was progressive and it required salvage operations.
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