Pulmonary mycobacteriosis in a patient with bronchiectatic disease: a clinical case

Background. Pulmonary mycobacteriosis (PMB) is a disease difficult to diagnose and treat, developing mainly in immunocompromised patients with HIV, as well as with a number of concomitant lung diseases, including bronchiectatic disease (BED). Description of the clinical case. A dynamic clinical observation of a young patient with a combination of BED and PMB is presented. The key stages of the diagnostic search and the difficulties of establishing a final diagnosis are described. A prolonged unsuccessful treatment of infiltrative tuberculosis of the left lung with the transition to cirrhotic tuberculosis was followed by surgery in the form of a resection of the left lung and a revision of the final diagnosis in favor of PMB. Moreover, the clinical observation demonstrated the interaction of PMB and BED in the form of an unfavorable comorbid situation in which the progression of both diseases is possible due to the ineffectiveness of the therapy. Conclusion The experience gained from the presented clinical observation can be useful to colleagues in the management of such comorbid patients. In therapeutic practice, patients with BED are quite often followed up by a doctor, but diagnostic search in terms of identifying PMB is carried out in detail in rare cases. At the same time, among patients with the presence of acid-resistant bacteria in the sputum and x-ray changes in the lungs, a diagnosis of tuberculosis is immediately established, which also does not exclude the diagnosis of PMB. The accumulation of experience in the therapeutic strategies for such patients will also be useful for creating an agreed document or recommendations for managing patients with a combination of these diseases.

bronchiectatic disease, pulmonary mycobacteriosis, antibiotic therapy, radiography, clinical observation