EVOLUTIA TUBERCULOZEI PULMONARE INFILTRATIVE IN PNEUMONIE CAZEOASA.CARAIANI OlgaInstitutul de Ftiziopneumologie Chiril Draganiu, ChisinauRecenzent: ZLEPCA V., dr. in medicina.Cuvinte cheie: tuberculiza pulmonara infiltrativa, pneumonia cazeoasa.Actualitatea temei: In ultimii ani se remarca modificarea considerabila a structurii si manifestarilor clinico-radiologice ale tuberculozei pulmonare, cresterea cazurilor cu evolutie progresiva a procesului, cu debut acut si eliminari masive de bacili [1]. Tuberculoza pulmonara infiltrativa ocupa primul loc in structura tuberculozei organelor respiratorii si alcatuieste 60-70% la bolnavii primar depistati [2;3]. Probleme creeaza si numarul mare de pacienti cu anamneza sociala si medicala agravata: somerii, migrantii, fumatorii, persoanele care fac abuz de alcool, infectia HIV si alta patologie asociata [4;5]. In forma acut-progresiva a tuberculozei pulmonare se include pneumonia cazeoasa de obicei este polisegmentara, unilaterala sau bilaterala. Tabloul clinic a pneumoniei cazeoase se manifesta prin: sindromul de intoxicatie, sindrom bronhoobstructiv, sindrom hemoptoic. Diagnosticul de pneumonie cazeoasa se stabileste cind se agraveaza starea generala a bolnavului. Pneumonia cazeoasa survine de obicei la persoane cu imunodeficienta exprimata ceea ce permite multiplicarea rapida a bacililor tuberculosi si diseminarea pe calea bronsica. Evolutia pneumoniei cazeoase este grav, dar in lipsa tratamentului specific poate fi letala [6].Obiectiv: Studierea cazurilor noi de tuberculoza pulmonara infiltrativa cu evolutie in pneumonie cazeoasa. Material si metode: S-au luat in studiu 55 de pacienti diagnosticati cu tuberculoza pulmonara infiltrativa caz nou, dintre care 24 cazuri au fost pneumonii cazeoase. Rezultate: Majoritatea bolnavilor au fost de sex masculin 86,93%, BK pozitivi in sputa 84,50%, au decedat 20,37% naintea de terminarea perioadei intensive de tratament. Vrsta medie a pacientilor decedati a fost de 45,09 ani, 81,81% au fost barbati. Adresarea tardiva a fost in 68,12% cazuri, neangajati in cmpul muncii 68,51% cazuri, celibatari 11,11% cazuri, migranti 12,96% cazuri. In 40,74% cazuri faceau abuz de alcool, 22,22% cazuri abandon, 12,96% cazuri MDR. Boli asociate: Alcoolism cronic 9,25%, Hepatita cronica si ciroza hepatica 7,40%, Diabet zaharat 3,70%, HIV/SIDA 1,85% cazuri.Concluzie: Evolutia tuberculozei pulmonare infiltrative in pneumonie cazeoasa a fost cauzata de adresarea tardiva, deprinderi nocive, nivelul social vulnerabil, abandon, MDR si prezenta bolilor concomitente.Bibliografie:1.Bloom B. Tuberculosis. Pathogenesis, protection, control. Asm. Press. // Washington, 1994, P 4-72. . ., . . , // . .,2009, 9, 16-193. . ., . . // . . 2002. 4. . 16-204.Halpern A. V., Spalatelu L. Assotiates disceaces and chronic tuberculosis. // Europ. Resp. Journ., 2003, Vol. 22, P. 1545.Kuruc V., Ilic M., Pavlovic S. The influence of social al and economic factor son incidence of tuberculosis. // Europ. Resp. Journ., 2005, Vol. 26, P. 12306.Didilescu C., Marica C. Tuberculoza trecut, prezent, viitor. Bucuresti, 2004, P.590-592

EVOLUTION OF INFILTRATIVE PULMONARY TUBERCULOSISIN CASEOUS PNEUMONIAOlga Caraiani Chiril Draganiu Institute of Phthisiopneumology, Chisinau, Republic of MoldovaKeywords: tuberculiza pulmonary infiltration, caseous pneumonia.Objective: The study of new cases of infiltrative pulmonary tuberculosis evolving in caseous pneumonia.Material and Methods: there were studied 55 patients diagnosed with infiltrative pulmonary tuberculosis new case, of which 24 cases were of caseous pneumonia.Results: Most patients were male 86.93%, 84.50% positive in sputum, 20.37% died before the end of intensive treatment period. The average age of deceased patients was 45.09 years, 81.81% were men. Late addressing was in 68.12% cases, unemployed in 68.51% cases, single in 11.11% cases, migrants in 12.96% cases. In 40.74% cases there were identified abuse of alcohol, abandonment in 22.22% cases, 12.96% cases of MDR. Associated diseases: 9.25% of chronic alcoholism, 7.40% of chronic hepatitis and cirrhosis, 3.70% of diabetes, HIV / AIDS 1.85% cases.Conclusion: The evolution of infiltrative pulmonary tuberculosis in caseous pneumonia was caused by late addressing, harmful habits, vulnerable social level, abandonment, MDR and the presence of concomitant diseases.