GENERALIZED TUBERCULOSIS IN A MILITARY PROCEEDING UNDER THE MASK OF SARCOIDOSIS. CLINICAL CASE

In recent years, the epidemiological situation of tuberculosis in Russia and the Armed Forces of the Russian Federation remains tense for a number of reasons. Including this fact is caused by untimely, sometimes posthumous, detection of tuberculosis. Late diagnosis of the disease is associated with a low-symptom or asymptomatic clinical course, the absence of pathognomonic radiological, laboratory, immunological signs of the disease, often the absence of bacterial excretion. The detection of tuberculosis is also difficult in the differential diagnosis with sarcoidosis, which is characterized by very similar clinical, radiological and even pathomorphological signs in the form of granulomatous inflammation. An analysis of a clinical case was carried out in which for a young man for about 1.5 years tuberculosis proceeded along the mask of sarcoidosis, which led to the generalization of a specific infection. Even after the start of an intensive examination using modern diagnostic methods, it took two months to go from the diagnoses of “lacunar tonsillitis”, “community-acquired pneumonia”, “sarcoidosis of the respiratory system”, “lymphoproliferative disease of unknown etiology” to the diagnosis “generalized tuberculosis” confirmed histologically. A decisive role in identifying the disease was played by biopsy methods followed by histological verification of the diagnosis. Thus, it is advisable for all patients with suspected sarcoidosis who are admitted to military medical organizations, regardless of the stage of the process and the results of the previous examination, to consult a TB specialist, performing a diagnostic minimum to exclude active tuberculosis (bibliography: 7 refs).

differential diagnosis, generalization, granulomatous inflammation, histological verification, pathomorphological studies, sarcoidosis, tuberculosis, tuberculosis mycobacteria