Abstract
The aim of the study. To analyze a clinical case and demonstrate the most rational research methods for the differential diagnosis of tuberculosis and sarcoidosis. Materials and methods of research. The article presents
an analysis of a complex clinical case of generalized tuberculosis, which for a long time could not be verified due to the lack of bacterial excretion and the similarity of clinical
and radiological manifestations with those of respiratory
sarcoidosis. Results. The patient’s disease developed and
proceeded asymptomatically, it was revealed during preventive fluorography of the UCP. Later, the young man
was periodically examined in various medical institutions
for about 18 months, tuberculosis was not diagnosed, the
disease proceeded under the “mask” of sarcoidosis. This
situation led to the generalization of a specific infection.
At the same time, even after the start of a permanent
specialized examination using modern diagnostic methods,
it took almost 4 months starting from the diagnoses of “lacunar angina”, “community-acquired pneumonia”, “sarcoidosis of the respiratory organs stage 2 in combination with lytic destruction of the 7th thoracic vertebra”, “lympho proliferative disease of unclear etiology”, the state of “differential diagnosis between sarcoidosis, tuberculosis, lymphoproliferative disease” before the diagnosis of “generalized tuberculosis” was confirmed histologically. Conclusion. Biopsy methods with subsequent histological verification of the diagnosis played a decisive role in the detection of the disease. Considering the above, it is advisable for all patients with suspected sarcoidosis who are admitted to medical institutions, regardless of the stage of the process and the results of the previous examination, to consult a phthisiologist, to perform diagnosis minimum before this to exclude active tuberculosis.