Silicotuberculosis - causes, symptoms, diagnosis and treatment

Silicotuberculosis - Pneumoconiosis caused by the inhalation of silica dust and complicated with pulmonary tuberculosis. Accession or the activation of tuberculosis infection is accompanied by worsening of silicosis: a rise in temperature, increase of intoxication, increased shortness of breath, cough with sputum appearance of purulent character, hemoptysis, progressive weight loss. Silicotuberculosis diagnosed based on professional and TB history, radiological and endoscopic picture, sputum for mycobacteria, tuberculin tests. Treatment is carried out anti silicotuberculosis of chemotherapy on the same principles as the treatment of tuberculosis.

  • Causes and classification silicotuberculosis
  • Symptoms silicotuberculosis
  • Diagnosis silicotuberculosis
  • Treatment and prognosis silicotuberculosis
  • Silicotuberculosis - treatment

  • Silicotuberculosis


    pneumoconiosis. It is known that in patients suffering from silicosis, tuberculosis occurs 3-7 times more frequently than in individuals without symptoms. According tuberculosis and pulmonology, the most common TB infection aggravates the course of nodular silicosis stage II-III, rarely - interstitial form of pneumoconiosis. So, if nodular silicosis stage I complicated with pulmonary tuberculosis in 15-20% of patients with stage II is already at 25-30% of patients, and stage III - in 60-70% of cases. In the early stages, in most cases there is a focal or infiltrative pulmonary tuberculosis, and later - fibrocavernous or disseminated form. For silicotuberculosis characteristic weighting for at silikoticheskogo and tuberculous processes.

    disseminated pulmonary tuberculosis) and without distinction of forms (silikotuberkulezny bronhoadenit, silikotuberkuloma, konglomerativnyh and destructive silicotuberculosis).

    According to the degree of activity of tuberculosis component distinguish active and inactive stages of the disease; by the presence /absence of bacilli - open (MBT +) and closed (MBT-) form. In formulating a diagnosis also takes into account the phase of tuberculous process: infiltration, decay, sowing, seal, resorption, calcification.

    The clinical course silicotuberculosis passes two periods. During the first of these significant clinical signs are absent. In the second period to the fore symptoms caused by the progression of TB infection (intoxication, the appearance of bacilli in the sputum, the changes in the hemogram and chest radiograph).

    flu, pneumonia or lung abscess. Current silicotuberculosis often complicated by pulmonary hemorrhage, spontaneous pneumothorax, pulmonary atelectasis, emphysema, pulmonary heart. In the later stages of diagnosed cardio-pulmonary insufficiency.

    pathologist or respiratory therapist; in the case of accession of tubercular process becomes necessary in consultation phthisiatrician patient. To diagnose silicotuberculosis paramount occupational exposure to quartz-bearing dust, as well as the history of TB (tuberculosis migrated in the past, or contact with the bacilli).

    Radiography of the lungs in silicotuberculosis may reflect a different picture: on the background of diffuse large-mesh fibrosis and silicosis typical symmetric nodular lesions in the middle and lower lobes appear tubercular lesions, infiltrates silikotuberkulomy, caverns, mainly located in terminal areas. The reliability of the diagnosis is confirmed by finding MBT in sputum or lavage of the bronchi. Bronchoscopy helps to visually identify dust pigmentation and signs of tubercular lesions of the bronchial mucosa.

    The differential diagnosis is carried out with silicosis, sarcoidosis, idiopathic fibrosing alveolitis, lung cancer. The most important criterion for confirming silicotuberculosis are positive tuberculin skin test. In severe cases the diagnosis is established only after diagnostic thoracotomy or destination trial of TB treatment.

    inhalation) routes of administration of isoniazid and rifampicin.

    Along with the anti-TB treatment is carried silicosis therapy (prednisone, bronchodilators, oxygen therapy, antioxidants and antihypoxants) and correction of cardio-respiratory failure.

    Current silicotuberculosis mostly unfavorable, the disease leads to the patient's disability. Prognosis depends on the stage of silicosis, tuberculosis, associated disorders. Any complications silicotuberculosis are factors aggravating the prognosis. All patients with silicosis should receive TB chemoprophylaxis.