It is believed that the melting of necrotic tissue occurs not only under the influence of proteolytic enzymes, but also with the assistance of the body�s immunobiological system. Until now, there is no exact answer to the question why the result of the inflammatory process in some patients is the appearance of caseous masses and subsequently cavities, while in others an exudative process develops that does not entail any special pathological changes.
Destructive changes with the formation of cavities occur against the background of certain conditions. They act as a catalyst for destructive disorders. The development of destruction most often occurs with infiltrative tuberculosis, less often associated with a disseminated complex. Also, the focal form and tuberculoma can cause the appearance of necrotic masses. The disease develops during the period of secondary infection, at the time of pathological changes in the lung tissue. Cases of rejection of caseous masses with the appearance of cavities and during the primary tuberculosis complex have been described. Therefore, the cause of this disease can be any clinical form of tuberculosis.
The main criterion for the clinical picture is an asymptomatic course. The patients feel well and have virtually no complaints. The symptoms are so mild that even the cough goes unnoticed, and the patient is unaware of its pathological component. The table shows the features of isotretinoin course of cavernous tuberculosis.
Symptom Severity of the clinical course Cough The symptom is not pronounced and may last a short time. Hemoptysis Does not occur in all patients (15%). The manifestation of bloody sputum is pronounced and indicates disturbances in the respiratory tract. Sputum is not the main symptom, the discharge is scanty and the doctor may not detect it. Wheezing Can be heard weakly and only in the place where the focus is localized. Bacterial excretion has a wave-like course. Periods of falling bacterial populations are followed by a sharp increase. Intoxication Increased temperature and the appearance of weakness are associated with the wave-like course of the disease. The outbreak period occurs due to ineffective treatment. Dynamics of leukograms: Slight increase in ESR, shift to the left, slight leukocytosis. It is possible that all indicators will remain within normal limits.
Along with tuberculosis symptoms, it is necessary to conduct studies for concomitant endobronchitis. The endobronchial process in this disease is not a rare phenomenon. In this case, the associated pathology will significantly impede the healing of the cavities. For such patients, it will be necessary to adjust the usual treatment tactics.
The main instructions for diagnosing the cavernous tuberculosis process are to conduct clinical, radiological and bacteriological research methods. Often laboratory parameters do not reveal changes, so the main diagnostic method is considered to be X-ray.
Important! On an x-ray (pictured), the cavity looks like a closed ring-shaped shadow, with clearly defined internal contours. The clearing inside the ring is the cavity window.
To identify bronchial lesions, it is necessary to perform instrumental bronchoscopy. The detection of mycobacteria in sputum characterizes an active process and signals the patient�s social danger to the people around him.
Therapeutic instructions are drawn up on the basis of general rules for the treatment of isotretinoin.
Anti-tuberculosis chemotherapy drugs are prescribed.
An effective course of treatment lasts about 5-6 months. With a favorable outcome, the caseous layer disappears, the cavity closes, and bacterial excretion stops.
If the MBC exhibits drug resistance and the cavity does not heal, then chemotherapy is considered ineffective. Failure of treatment can transform the process into fibrocavernous tuberculosis. An unfavorable outcome of the disease leads to a significant change in the approach to treatment - lung resection or artificial pneumothorax is performed.
Cavernous pulmonary tuberculosis is characterized by the presence of a formed cavity. This is its main distinguishing feature. Cavernous pulmonary tuberculosis is essentially an intermediate stage in the progressive course of destructive tuberculosis. This stage occupies a place between the decay phase of one or another clinical form of tuberculosis and fibrous-cavernous tuberculosis. The decay phase of any clinical form of pulmonary tuberculosis is the beginning of the destructive process, with progressAs it progresses, the signs of the initial clinical form gradually disappear, especially under the influence of chemotherapy, as the inflammatory process involutions. Features of the disease caused by the presence of an emerging or already formed cavity come to the fore.
Why does this course of tuberculosis occur? Apparently, the inflammatory reaction in tuberculosis can be classified in individual patients or in a separate group of patients as a hyperergic reaction, as an inflammatory reaction that occurs against the background of pronounced local local sensitization. More often, the destructive process is observed with infiltrative pulmonary tuberculosis. More than 40% of newly diagnosed patients with this form of tuberculosis have already decayed, and this percentage remains stable and there is no tendency to buy accutane online.
Quite often, the destructive process is detected in patients with disseminated pulmonary tuberculosis, however, the share of this form in the overall structure of morbidity is not very large, but among all newly diagnosed patients with disseminated tuberculosis, 40% of people show decay at different stages of development. Focal tuberculosis can also lead to the formation of destructive forms. How to identify a destructive process? How to detect it in the early stages before cavernous pulmonary tuberculosis forms?