Clinical presentation and diagnosis of tuberculosis comorbidity, pneumocystis carinii, herpes and cytomegalovirus pneumonia in patients with immunodeficiency in advanced stages of HIV infection.
DOI:
https://doi.org/10.52692/1857-0011.2025.3-83.05Keywords:
comorbidity, tuberculosis, pneumocystis pneumonia, herpesvirus pneumonia, cytomegalovirus pneumonia, HIV infection, immunodeficiency, microbiological diagnostics, molecular genetic diagnostics, radiation diagnostics.Abstract
The features of clinical manifestations in comorbidity of tuberculosis, pneumocystis carinii and herpesvirus pneumonia in 25 patients and in comorbidity of tuberculosis, pneumocystis carinii pneumonia and cytomegalovirus pneumonia in 21 patients (1a and 2a main groups) were studied in comparison with the same 25 and 21 patients without pneumocystis pneumonia (control groups 1b and 2b), stage 4B and 5 of HIV infection, in the progression phase and in the absence of antiretroviral therapy. All patients suffered from drug addiction, consumed alcoholic beverages and smoked tobacco products, and also had secondary diseases: viral hepatitis B or C and chronic obstructive pulmonary disease (in 66.3%). It has been established that this comorbidity is characterized by pronounced immunodeficiency with a CD4+ lymphocyte count of less than 50 cells/μl of blood and a viral load of more than 500,000 RNA copies of HIV/ml of blood and generalization of tuberculosis with multiple extrapulmonary lesions. The clinical picture was characterized by a syndrome of intoxication, general inflammatory and respiratory manifestations, and CT of the chest organs visualized a complex of a simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy, and the area of lung damage in all patients was 80-100%. This determines the similarity of clinical manifestations and visualization of CT changes in this comorbidity, which makes it difficult to distinguish them due to the simultaneous layering of several pathologies with the same type of clinical manifestations and requires a comprehensive
etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the mortality rate of this severe contingent of patients.
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