Silicotuberculosis ( koniotuberkulez )
Occupational Diseases / / August 12, 2017
Tuberculosis is the most common and most serious complication of silicosis.Two inter-related pathological process heavier and modify each other.There are indications that Mycobacterium tuberculosis with silicosis morphologically changed.Thus, silicotuberculosis - not a simple combination of the two diseases, and a new, unified, originally flowing process.Clinic silicotuberculosis polymorphic and depends on the nature and stage silicosis, and the shape and phase of tuberculosis.The more pronounced silicosis, more often, more quickly and more severe forms of tuberculosis it is complicated.Silicosis stage I usually accompanies focal tuberculosis, with stage II and III dominates infiltrative, in advanced cases - fibrocavernous.However, sometimes when silicosis stage I observed more severe forms of tuberculosis.
Upon accession tuberculosis observed more rapid progression of silicosis.At the same time, and tubercular process takes a more active, severe course, sometimes giving aggravation have for 1st - 2nd
main complaints when silicotuberculosis: frequently and early (often long before the X-ray changes) cause shortness of breath, chest pain, cough, weakness, fatigue, malfunction, night sweats.In the light - box sound above the lower lobes, shortening pitch respectively over the affected areas.Breathing hard, or bronchial, common dry and mixed wet rales, pleural friction.Persistent low-grade fever (not always), increased erythrocyte sedimentation rate, leukocyte formula shift to the left, lymphopenia, monocytosis, moderate hypochromic anemia.Positive tuberculin skin test.Mycobacteria in sputum often not determined.TB process can proceed almost no symptoms for a long time.Then, under the influence of cooling, other diseases, and sometimes for no apparent reason comes exacerbation followed by rapid passage.
silikozoopasnyh In particular professions (in Sandblasting, obrubschikov casting, working the gold mining industry, and others.) There is a more severe atypical for silicotuberculosis.
Differential diagnosis between silicotuberculosis and "clean" silicosis is sometimes very difficult.In tubercular character defeats indicate localization of morphological changes in the subclavian areas and the tops of the lungs, the asymmetric localization, polymorphism and variability of shadow formations.Characterized by acute or subacute onset of the disease, the severity of clinical manifestations in comparison with the data of X-ray examination, symptoms of intoxication, positive tuberculin test.Finding Mycobacterium tuberculosis and elastin fibers in the sputum finally solves the problem.On the contrary, the "pure" silicosis say great experience with silica dust, the relative poverty of clinical symptoms, slow development, the symmetry of the lesions, the absence of toxic effects, the temperature of the reaction.
Despite the possibility of uncomplicated silicosis stage III, due to frequent tuberculosis connection is recommended to almost all cases of silicosis stage III treated as silicotuberculosis in order to conduct appropriate therapy.Silicotuberculosis more often than "pure" silicosis, complicated spontaneous pneumothorax.