DIAGNOSIS OF NONTUBERCULOUS MYCOBACTERIAL INFECTION

Abstract

After the discovery of the causative agent of tuberculosis by R. Koch, clinicians had the opportunity to diagnose it etiologically. The detection of the causative agent of Mycobacterium tuberculosis (MTB) in biological media is assessed as a reliable confirmation of the diagnosis of tuberculosis infection [1]. The material for verifying the diagnosis of pulmonary tuberculosis is respiratory (sputum, bronchoalveolar lavage fluid, BAL) and other (operational, biopsy) diagnostic material obtained from pathological Hearth. The main reason for the absence of the causative agent of tuberculosis in the respiratory material is its insignificant amount in the focus of inflammation. It should be noted that in a pathological process in the lungs not related to the bronchi, and/or in the presence of their structural deformities or obstruction, there is also an obstacle to the detection of the pathogen in the respiratory material. In such situations, it is difficult or impossible to obtain diagnostic material and pathogen for microbiological research using traditional methods, and to make a diagnosis, the doctor has to be guided mainly by epidemiological, clinical and radiological data, the results of biochemical, immunological and molecular genetic studies with an assessment of these changes in dynamics [2, 3]. Due to the importance of diagnosing pulmonary tuberculosis even in the absence of bacterial excretion in patients, we collected and analyzed literature data on additional methods and methods for obtaining samples of material for microbiological and other studies in order to detect tuberculosis. In the course of the literature search, an analysis of methods that allow indirectly judging the presence of the causative agent of tuberculosis (for example, immunological and radiation methods) was carried out.  including the use of mathematical modeling. We have analyzed the methods and methods available in phthisiatric practice for diagnosing pulmonary tuberculosis with unproven bacterial excretion in the presence of clinical and radiological signs of the activity of the process in patients.