Difficulties of the stage-by-stage surgical treatment of a teenager with bilateral advanced fibrotic-cavernous tuberculosis. Сlinical case
- Authors: Tarasov R.V.1,2,3, Lepekha L.N.1, Sadovnikova S.S.1, Krasnikova E.V.1, Asoyan G.A.1, Zakharova A.M.2, Bagirov M.A.1,3
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Affiliations:
- Central Research Institute of Tuberculosis
- Medical University "Reaviz"
- Russian Medical Academy of Continuous Professional Education
- Issue: Vol 28, No 3 (2024)
- Pages: 306-315
- Section: CASE REPORTS
- Submitted: 24.08.2023
- Accepted: 16.10.2023
- Published: 13.07.2024
- URL: https://jps-nmp.ru/jour/article/view/725
- DOI: https://doi.org/10.17816/ps725
- ID: 725
Cite item
Abstract
BACKGROUND: To achieve success in the management of adolescents with tuberculosis, a comprehensive approach including surgical intervention is needed so as to eliminate disease clinical manifestations, to achieve persistent healing of tuberculous changes with restoration of bodily functions and complete social rehabilitation
CLINICAL CASE DESCRIPTION: In patient U., 17 y.o., sudden and acute onset of the disease broke out after her contacts with her aunt who had tuberculosis. The initial form was infiltrative pulmonary tuberculosis in the decay phase. A course of anti-tuberculosis therapy was prescribed considering the bacteria sensitivity to antibiotics. After the course, fibrous lesions and cavities were detected in both lungs at computed tomography examination of the chest organs. A personalized therapy was developed for the patient with consideration of her body weight and sensitivity to bacteria. In 7 months, an endobronchial valve was inserted at the bronchus mouth in the right superior lobe because of the large cavity in the right upper lung lobe and lack of changes in the cavity size. In six more months, the blocker was removed due to the lack of dynamics, and a video-assisted thoracoscopic combined resection of the right lung (upper lobectomy with resection of part SV, anatomical resection SVI with part SVIII) was performed. On analyzing surgical material, it was found out that the patient was resistant to Isoniazid, Rifampicin and fluoroquinolones, so therapy was corrected. In six months, a video–assisted thoracoscopy combined resection of the left lung (SI–III anatomical resection and marginal resection of SVI part) was made.
CONCLUSION: After the performed treatment, patient's oxygenation improved, persistent abacillation was achieved, due to which the patient could return to normal lifestyle.
Full Text
About the authors
Ruslan V. Tarasov
Central Research Institute of Tuberculosis; Medical University "Reaviz"; Russian Medical Academy of Continuous Professional Education
Author for correspondence.
Email: etavnai@yandex.ru
ORCID iD: 0000-0001-9498-1142
SPIN-code: 4245-1560
Scopus Author ID: 211623482
ResearcherId: AGK-3113-2022
MD, Cand. Sci. (Medicine), Associate Professor
Россия, Moscow; Moscow; MoscowLarisa N. Lepekha
Central Research Institute of Tuberculosis
Email: lep3@yandex.ru
ORCID iD: 0000-0002-6894-2411
SPIN-code: 6228-8382
Dr. Sci. (Biology), Professor
Россия, MoscowSvetlana S. Sadovnikova
Central Research Institute of Tuberculosis
Email: sadovnikova.sv@mail.ru
ORCID iD: 0000-0002-6589-2834
MD, Dr. Sci. (Medicine)
Россия, MoscowElena V. Krasnikova
Central Research Institute of Tuberculosis
Email: el.krasn@gmail.com
ORCID iD: 0000-0002-5879-7062
SPIN-code: 4252-8340
MD, Dr. Sci. (Medicine)
Россия, MoscowGenrik A. Asoyan
Central Research Institute of Tuberculosis
Email: henoasoyan@gmail.com
ORCID iD: 0000-0003-2927-7495
SPIN-code: 6213-7691
MD
Россия, MoscowAlexandra M. Zakharova
Medical University "Reaviz"
Email: alexandra-turunen@yandex.com
ORCID iD: 0000-0001-5450-2610
MD
Россия, MoscowMammad A. Bagirov
Central Research Institute of Tuberculosis; Russian Medical Academy of Continuous Professional Education
Email: bagirov60@gmail.com
ORCID iD: 0000-0001-9788-1024
SPIN-code: 8820-5448
MD, Dr. Sci. (Medicine), Professor
Россия, Moscow; MoscowReferences
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