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Cavernous pulmonary tuberculosis requires complex treatment in a hospital setting. The patient is prescribed 4-5 medications daily. Treatment lasts from 6 to 20 months. Anti-tuberculosis chemotherapy consists of 4 mandatory components.
If the patient is taking drugs that suppress the immune system, for successful treatment of tuberculosis they should be discontinued or the dose should be reduced as much as possible. Glucocorticoids for tuberculosis are prescribed only during periods of acute inflammation in combination with chemotherapy. Doctors try to limit the period of their use and select the minimum doses. This is due to the immunosuppressive effect of adrenal hormones.
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Surgical treatment must be combined with medications. Additionally, valve bronchoblocking is used - a modern method that allows one to avoid surgical intervention in the treatment of cavities with thick walls. Bronchoblocking cannot completely replace surgery, but in some cases it helps stop the pathological process and avoid postoperative complications.
Many modern specialists add fluoroquinolone derivatives to these drugs. The disadvantages of conventional therapy are its high cost and a large number of adverse reactions. If cavernous tuberculosis cannot be cured with medication, the patient has the affected area of the lung surgically removed. Indications for surgical intervention are as follows.
Cavernous pulmonary tuberculosis is curable. Small cavities close and a scar forms in their place. In place of large cavities, a sanitized cavity or tuberculoma is formed. Complications arise from improper therapy. Mycobacteria develop resistance to anti-tuberculosis drugs, and the pathological process spreads to the second lung. The following complications of cavernous tuberculosis are distinguished.
In the absence of special therapy, in half of the patients, death occurs after 2-3 years; in the other half, the disease becomes chronic. A method of specific prevention of tuberculosis is vaccination. The first vaccination is given to children in the maternity hospital. Revaccination is carried out at 7 and 14 years of age. The vaccine does not always prevent infection with tuberculosis, but vaccinated people get a mild form of the disease.
Tuberculosis is a very ancient disease that is still extremely common in modern society and even if it no longer claims millions of lives as it did just a little over a hundred years ago, it is still very dangerous. Despite the fact that the causative agent of tuberculosis is always the same, this disease is striking in its diversity. It is capable of attacking various types of living beings, any tissues of the body, and also has a fairly wide variety of forms of occurrence. One of these forms is cavernous pulmonary tuberculosis, which also represents a stage in the development of the inflammatory process of lung tissue under the influence of a pathogen.
Cavernous tuberculosis or destructive pulmonary tuberculosis is a stage of the disease in which the disease progresses with the destruction of the lung tissue, in place of which, instead of fibrous formations or, in other words, scars, thin-walled cavities appear - cavities.
Caverns in the lungs arise most often in adult patients, almost never affecting children. A cavity forms in the lung with any form of tuberculosis, if it progresses or is complicated by a change in the body’s reactivity, massive infection, increased sensitivity, perhaps even a severe allergy to the toxins of the pathogen or to itself, bad habits or the development of concomitant diseases. To clearly imagine what a cavern is, it is necessary to understand the process of its formation and evolution, which occurs as follows.
First, the lung tissue inside the focus of tuberculous inflammation will disintegrate and degenerate into caseous masses, which are the result of the death of various cells. Next, the caseous masses turn into a liquid mixture of pus, blood, immune and pathogenic cells. When cavernous tuberculosis progresses, the cavity breaks through and its contents enter the nearest bronchus, and the disease becomes open, as liquid caseous masses rich in a large number of pathogenic bacilli begin to be released with sputum into the environment.
Alternatively, due to the complicated course, there is a risk of the formation of pleural empyema (inflammation of the pleural layers), bronchial fistula (a hole in the bronchus opening into the pleural cavity, the lumen between internal organs or even the environment), as well as multiple contamination of the lungs or the whole body . After the contents are released, the empty cavity is filled with air, however, it can no longer perform the previous functions of gas exchange.