肺結核の悪化について

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Aggravation of pulmonary tuberculosis is usually defined simply as positive conversion of tubercle bacilli in sputum or reactivation of radiological findings. Among them, however, some episodes are not significant during the clinical course of tuberculosis. In order to analyse these points, 85 patients who were diag n osed as having an aggravation of tuberculosis according to the above mentioned criteria and readmitted to our hospital during the period from 1967 to 1972 were studied. Based on the results of follow up of cases with different kinds of so called bacteriological relapse solely, radiological relapse solely and both bacteriological and radiological relapses, following conclusions were obtained. The following three findings which were found among cases showing negative sputum both on smear and culture for more than 3 months are considered to have no significant meaning in the clinical course of pulmonary tuberculosis (minor aggravation): 1) Smear positive culture negative findings observed less than three co n secutive times without radiological aggravation. 2) Small amount of positive bacilli on culture (less than 20 colonies) observed only once without radiological aggravation. 3) Worsened radiological findings without bacilli discahrge and improved markedly within two months. Cavitation observed during the treatment of tuberculoma showing gradual decrease in its size on X-ray film should not be regarded as aggravation.
日本結核病学会の論文

肺結核の悪化について

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