Year: 2024
Type: article
Study design: Case Report
Abstract: The complexity of the differential diagnosis of tuberculosis is due to a combination of factors that lead to diagnostic difficulties and errors. At the forefront of this variability are: the similarity of the clinical and radiological picture of lung diseases with the absence of pathognomonic signs; the pathomorphosis and variability of clinical manifestations of lung diseases, where there is often a diversity of clinical variants of the same nosology. Some diseases with no established etiology (such as sarcoidosis and obliterative bronchiolitis) often mimic tuberculosis. At the current stage, the arsenal of tools that allows for the timely detection and diagnosis of the etiology of pathological changes in the lungs includes a recombinant tuberculosis allergen test (ATR) — the Diaskintest® preparation. Immunodiagnostics plays a leading role in establishing the presumed diagnosis of tuberculosis. This method allows for effective screening not only for active tuberculosis but also for latent tuberculosis infection in individuals with non-tuberculous lesions of the chest organs. Thus, Diaskintest® successfully addresses the issues of detection and differential diagnosis in real clinical practice within diagnostic algorithms for excluding tuberculosis. The article presents a clinical observation of newly diagnosed pulmonary tuberculosis in a 30-year-old man. A distinctive feature of this case is that, in the absence of detection of the tuberculosis pathogen in the early stages of the disease, it was the positive result of the Diaskintest that guided the diagnostic search. As further examination results showed, the probable diagnosis established based on the positive ATR test completely matched the verified diagnosis of tuberculosis. The use of the ATR test allowed for a reduction in the diagnostic pause interval and the timely initiation of appropriate therapy for the patient, even with a negative microscopy result during the differential diagnosis stage.
DOI: 10.21518/ms2024-445
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405342358