Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency
Aim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency. Materials and methods. The prospective study include...
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| Format: | Article |
| Language: | Russian |
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ZAO "Consilium Medicum"
2023-09-01
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| Series: | Consilium Medicum |
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| Online Access: | https://consilium.orscience.ru/2075-1753/article/viewFile/609529/138170 |
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| author | Vladimir Y. Mishin Anastasiia V. Mishina Dmitry A. Lezhnev Aleksandr L. Sobkin Ivan V. Shashenkov |
| author_facet | Vladimir Y. Mishin Anastasiia V. Mishina Dmitry A. Lezhnev Aleksandr L. Sobkin Ivan V. Shashenkov |
| author_sort | Vladimir Y. Mishin |
| collection | DOAJ |
| description | Aim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency.
Materials and methods. The prospective study included 120 newly identified patients with disseminated pulmonary tuberculosis with Mycobacterium tuberculosis, stage IVB of HIV infection, in the phase of progression and in the absence of antiretroviral therapy, aged 2953 years, who were randomized into 1A and 2A main groups and 1B and 2B comparison groups. Group 1A included 29 patients with comorbidity and pneumocystis pneumonia and group 2A 31 patients with comorbidity of disseminated pulmonary tuberculosis, coronovirus pneumococcal pneumonia, and group 1B and 2B comprised 29 and 31 similar patients, but without coronovirus pneumonia. To diagnose coronavirus pneumonia, PCR of SARS-CoV-2 RNA was used in smears from the nasopharynx and oropharynx, in sputum or in endotracheal aspirate. To detect Pneumocystis jirovecii, the causative agent of pneumocystis pneumonia, a microscopic examination of diagnostic material from the respiratory tract with RomanovskyGiemse and GrokottGmri coloration was carried out, and to detect Streptococcus pneumoniae, the causative agent of pneumococcal pneumonia, the diagnostic material was seeded on special nutrient media with determination of the drug resistance of the resulting culture to broad-spectrum antibiotics. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval.
Results. The comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients in the late stages of HIV infection, in the phase of progression and in the absence of antiretroviral therapy was characterized by severe immunodeficiency, generalization of tuberculosis with multiple extrapulmonary lesions and severe pneumonia. This determines the similarity of clinical manifestations and respiratory symptoms, and also makes it difficult to visualize computed tomographic changes consisting of a complex simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy. Simultaneous layering of several pathologies with the same type of clinical manifestations and computed tomographic changes requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients.
Conclusion. Patients with disseminated pulmonary tuberculosis and HIV infection who are registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of COVID-19 infection and the development of coronavirus pneumonia, and with severe immunodeficiency, pneumocystis and pneumococcal pneumonia, should be regularly subjected to preventive studies for timely detection of COVID-19, coronavirus, pneumocystis and pneumococcal pneumonia for the purpose of their emergency isolation and timely treatment. |
| first_indexed | 2024-04-24T23:42:57Z |
| format | Article |
| id | doaj.art-0aa6f74d75e7458bad918d3969510198 |
| institution | Directory Open Access Journal |
| issn | 2075-1753 2542-2170 |
| language | Russian |
| last_indexed | 2024-04-24T23:42:57Z |
| publishDate | 2023-09-01 |
| publisher | ZAO "Consilium Medicum" |
| record_format | Article |
| series | Consilium Medicum |
| spelling | doaj.art-0aa6f74d75e7458bad918d39695101982024-03-15T09:57:58ZrusZAO "Consilium Medicum"Consilium Medicum2075-17532542-21702023-09-0125955155710.26442/20751753.2023.9.2022714717Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiencyVladimir Y. Mishin0https://orcid.org/0000-0002-4134-530XAnastasiia V. Mishina1https://orcid.org/0000-0002-3340-5843Dmitry A. Lezhnev2https://orcid.org/0000-0002-7163-2553Aleksandr L. Sobkin3Ivan V. Shashenkov4https://orcid.org/0000-0003-0233-7072Yevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryYevdokimov Moscow State University of Medicine and DentistryZakharyin Tuberculosis Clinical Hospital №3Yevdokimov Moscow State University of Medicine and DentistryAim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency. Materials and methods. The prospective study included 120 newly identified patients with disseminated pulmonary tuberculosis with Mycobacterium tuberculosis, stage IVB of HIV infection, in the phase of progression and in the absence of antiretroviral therapy, aged 2953 years, who were randomized into 1A and 2A main groups and 1B and 2B comparison groups. Group 1A included 29 patients with comorbidity and pneumocystis pneumonia and group 2A 31 patients with comorbidity of disseminated pulmonary tuberculosis, coronovirus pneumococcal pneumonia, and group 1B and 2B comprised 29 and 31 similar patients, but without coronovirus pneumonia. To diagnose coronavirus pneumonia, PCR of SARS-CoV-2 RNA was used in smears from the nasopharynx and oropharynx, in sputum or in endotracheal aspirate. To detect Pneumocystis jirovecii, the causative agent of pneumocystis pneumonia, a microscopic examination of diagnostic material from the respiratory tract with RomanovskyGiemse and GrokottGmri coloration was carried out, and to detect Streptococcus pneumoniae, the causative agent of pneumococcal pneumonia, the diagnostic material was seeded on special nutrient media with determination of the drug resistance of the resulting culture to broad-spectrum antibiotics. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval. Results. The comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients in the late stages of HIV infection, in the phase of progression and in the absence of antiretroviral therapy was characterized by severe immunodeficiency, generalization of tuberculosis with multiple extrapulmonary lesions and severe pneumonia. This determines the similarity of clinical manifestations and respiratory symptoms, and also makes it difficult to visualize computed tomographic changes consisting of a complex simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy. Simultaneous layering of several pathologies with the same type of clinical manifestations and computed tomographic changes requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients. Conclusion. Patients with disseminated pulmonary tuberculosis and HIV infection who are registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of COVID-19 infection and the development of coronavirus pneumonia, and with severe immunodeficiency, pneumocystis and pneumococcal pneumonia, should be regularly subjected to preventive studies for timely detection of COVID-19, coronavirus, pneumocystis and pneumococcal pneumonia for the purpose of their emergency isolation and timely treatment.https://consilium.orscience.ru/2075-1753/article/viewFile/609529/138170comorbiditydisseminated pulmonary tuberculosiscovid-19coronavirus pneumoniapneumocystis pneumoniapneumococcal pneumoniahiv infectionimmunodeficiencymicrobiological diagnosticsmolecular genetic diagnosticsradiation diagnostics |
| spellingShingle | Vladimir Y. Mishin Anastasiia V. Mishina Dmitry A. Lezhnev Aleksandr L. Sobkin Ivan V. Shashenkov Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency Consilium Medicum comorbidity disseminated pulmonary tuberculosis covid-19 coronavirus pneumonia pneumocystis pneumonia pneumococcal pneumonia hiv infection immunodeficiency microbiological diagnostics molecular genetic diagnostics radiation diagnostics |
| title | Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency |
| title_full | Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency |
| title_fullStr | Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency |
| title_full_unstemmed | Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency |
| title_short | Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency |
| title_sort | features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis coronavirus pneumocystis and pneumococcal pneumonia in patients with late stages of hiv infection with immunodeficiency |
| topic | comorbidity disseminated pulmonary tuberculosis covid-19 coronavirus pneumonia pneumocystis pneumonia pneumococcal pneumonia hiv infection immunodeficiency microbiological diagnostics molecular genetic diagnostics radiation diagnostics |
| url | https://consilium.orscience.ru/2075-1753/article/viewFile/609529/138170 |
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