Infiltrative tuberculosis is a secondary form of tuberculosis and occurs mainly in adults. Infiltrate develops as a result of inflammation located around fresh foci. Often the stage of development of fresh foci in the lungs remains invisible, and the disease is diagnosed already at the stage of the formed infiltrate.
Usually infiltrative tuberculosis affects several pulmonary lobules, a subsegment, a segment or the entire lobe of the lung. The clinical picture of the disease is nonspecific, and it is very difficult to identify the symptoms of the disease.
As the medical history usually shows, infiltrative tuberculosis can begin acutely or subacutely and often resembles a flu or pneumonia clinic. Body temperature rises rapidly to high numbers - 38-39C. The patient feels general weakness, sometimes there is pain in the chest area , a dry and then wet cough with sputum, sometimes with a small amount of blood.
If infiltrative tuberculosis begins acutely, it is often diagnosed as flu or pneumonia. It should be remembered that after one to two weeks, even without treatment or with incorrect treatment, the general condition of the patient may improve slightly, which is accompanied by a decrease in temperature. This is due to the fact that the decay of the infiltrate occurs with the coughing up of caseous masses. As a result, the absorption of toxic products and intoxication are reduced. The patient and the doctor calm down, while infiltrative tuberculosis progresses. After a while, all the symptoms of the disease resume.
If infiltrative tuberculosis develops gradually, which is observed in approximately 40% of cases, patients complain of fatigue, loss of appetite, general weakness, sweating, transient subfebrile condition, and a slight cough. Often, such patients do not pay attention to these symptoms, which are associated with overwork and smoking.
In the history of the development of the disease of some patients, there is evidence of contact with a patient with tuberculosis, or focal changes in the lungs revealed, or focal tuberculosis transferred in the past .
When examining a person suffering from infiltrative pulmonary tuberculosis, often do not reveal any special deviations from the norm. Only in some cases there is a noticeable decrease in body weight, a slight lag in the respiratory excursion of one half of the chest. Palpation makes it possible to identify the tension of the muscles of the shoulder girdle from the affected side, a change in voice trembling over the area of infiltration. A change in percussion sound in the direction of blunting can be noticed only with infiltrates with a diameter of more than 4 cm, lying at a depth of not more than 4 cm from the outer surface of the chest. Auscultation of breathing above the site of specific inflammation can be hard, with an extended exhalation, sometimes weakened as a result of impaired bronchial patency. With the decay of the infiltrate, moist fine and medium bubbling rales are heard.
In the process of effective treatment of infiltrative tuberculosis, its complete resorption is possible. Such cases from their own practice can lead many TB doctors. But, as almost every medical history in TB studies shows, infiltrative tuberculosis leads to the formation at the site of specific inflammation of the compacted foci against the background of more or less pronounced fibrotic changes. Sometimes perifocal infiltration resolves, and the caseous center of the focus is encapsulated. Depending on the size of such encapsulated caseosis, a bullet or tuberculoma lesion is formed. If the infiltrate is not completely absorbed and grows with connective tissue, an inductive field forms in its place. Due to the shrinkage of lobar infiltrates, cirrhosis of the lobe of the lung can form. With ineffective treatment, the decay cavity does not heal, its fibrous walls form. In this case, infiltrative tuberculosis goes into more complex forms of the disease - cavernous or fibrous-cavernous.