Isolation of non-spore-forming anaerobic bacteria from patients with tuberculosis of the lungs and other diseases of the respiratory organs

The use of specific means in bacteriological examination for anaerobic microflora in patients with purulent inflammatory diseases of the lungs including ones developing in the presence of pulmonary tuberculosis was validated. Isolation of nonsporulating anaerobic bacteria in monocultures or as a component of polymicrobial associations was shown important for correct diagnosis and using of etiotropic therapy and respective therapeutic measures. This should enable to prevent or to limit development of severe destructive affections of the lungs.     

Morphological diagnosis of tuberculosis and some disseminated diseases of the lungs

Based on the results of light optic and electron microscopic studies of lung tissue biopsy specimens from patients with disseminated tuberculosis (n = 31), sarcoidosis (n = 46), exogenous allergic alveolitis (n = 22), the authors present a set of various morphological signs of specific inflammation, which are detectable both in the area of a focus and in its adjacent sites. The set allows the diagnosis of the most common granulomatoses of the lung to be verified.     

Morphological diagnosis of chronic bronchitis in patients with tuberculosis of the lungs]

A morphofunctional insufficiency of the bronchial epithelium which is a pathognomonic symptom of chronic bronchitis, was examined in 105 biopsy specimens of the bronchial mucosa of patients with different forms of pulmonary tuberculosis by morphometry. It was found that epithelial changes typical of chronic bronchitis, were observed in 100% of the cases. However, 64.76% of the patients had Stages I and II morphofunctional insufficiency, which corresponded to the presence of chronic nonobstructive bronchitis. The epithelial changes traced in the remaining observations were characteristic of chronic obstructive bronchitis. The presence and the extent of morphofunctional insufficiency were not associated with the form of tuberculosis. The examination of biopsy specimens of the bronchial mucosa taken in the vicinity of the upper bronchus spur is considered to be an adequate and sufficient method of an objective detection of chronic bronchitis in tuberculosis.     

Clinico-immunologic characteristics of patients with pulmonary tuberculosis, psychic diseases and a congenital glucose-6-phosphate dehydrogenase deficiency

Clinical and immunological characteristics of the tuberculosis process in patients with mental diseases and congenital deficiency of glucose-6-phosphate dehydrogenase were investigated. Enzymopathy was detected in 34 (8.9 per cent) out of 382 patients subjected to the investigation. It was shown that among the carriers of the anomalous gene, the proportion of patients with chronic destructive tuberculosis was high. The patients (91.2%) showed more frequent bacterial isolation. Despite immunotherapy, no positive changes in the immunological indices were observed in the carriers, which was attributable to decreased activity of the enzyme in the immunocompetent cells.     

Developmental disorders of the lungs and tuberculosis]

Surgical biopsy of 536 pulmonary tuberculosis patients was analysed. It was found that in 90% of them tuberculosis developed in the malformed segment of lung tissue. Among the defects, basic matter was composed of small hypoplasia zones (2-3 cm) which were detected only morphologically. In 89% of the cases, zones of hypoplasia and cysts were located in the 1st and 2nd lung segments, which formed in the first postnatal months. In all cases tuberculosis affected the malformed bronchus, which was probably the primary site of tuberculosis process dissemination.     

Investigation of Burkholderia cepacia nosocomial outbreak with high fatality in patients suffering from diseases other than cystic fibrosis

Over a 1-y period, 26 inpatients at the Jordan University Hospital in Amman were detected with bacteraemia (23 cases) or respiratory tract colonized with B. cepacia (3 cases). A combination of genetic identification and molecular typing has proved that all cases were caused by a single epidemic strain of B. cepacia genomovar IIIa. Nosocomial infections could be documented in 21/26 (81%) patients, mostly with severe underlying or malignant diseases other than cystic fibrosis, but the source of infection was undetected. The overall mortality related to infection with B. cepacia was 42%. All B. cepacia isolates were resistant to ampicillin, amikacin, carbenicillin and gentamicin; and mostly susceptible to piperacillin, chloramphenicol, cotri-moxazole, tetracycline, ceftazidime, and tazocin (62-88%). This study demonstrates the nosocomial and high fatality of B. cepacia genomovar IIIa in Jordanian patients suffering from diseases other than cystic fibrosis.     

Esophageal diseases in the differential diagnosis of patients with angina pectoris symptoms

It is reported on 7 patients who on account of angina pectoris symptoms came to the consulting hour. A heart disease could be excluded. Since the complaints persisted the diagnostics was continued. Twice were found a carcinoma of the oesophagus, three times an oesophagitis and once an ulcer in the oesophagus and once a hiatal hernia. In unclear thoracic pain diseases of the oesophagus should always be included into the differential diagnosis. An adequate diagnostics must be performed.