Acta clinica Croatica, Vol. 39 No. 3, 2000.
Case report
Clinical Picture of Pulmonary Tuberculosis at the End of the Second Millennium
Ivan Grbac
Silvestra Smolčić
Davor Jurman
Senka Broz
Abstract
Over the last 120 years, a great progress has been made in the diagnosis and treatment of pulmonary tuberculosis. In Western Europe, the incidence of pulmonary tuberculosis was 700/100,000 at the beginning, and 10-20/100,000 at the end of the 20th century. Changes in the epidemiological pattern entailed modifications in the clinical picture of pulmonary tuberculosis over the mentioned period of time, so that at the end of the century (and millennium) four forms of the disease could be defined: 1) active pulmonary tuberculosis in patients with post-tuberculosis sequels; 2) active pulmonary tuberculosis not associated with other diseases; 3) active pulmonary tuberculosis associated with chronic diseases; and 4) active pulmonary tuberculosis in immunocompromised patients. It is emphasized that an increase in the number of group 3 and 4 active pulmonary tuberculosis patients should be expected in the third millennium. The detection and management of these patients are difficult and complex. The detection of pulmonary tuberculosis is relatively late, while the treatment often fails and leads to development of resistant Mycobacterium tuberculosis strains. The existent problems encountered in the management of tuberculosis patients could be minimized by the use of DOTS program, recommended by the World Health Organization and also by the Ministry of Health of the Republic of Croatia.
Keywords
Tuberculosis pulmonary, epidemiology; Tuberculosis pulmonary, prevention and control
Hrčak ID:
14968
URI
Publication date:
1.9.2000.
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