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The role of Diaskintest in detecting tuberculosis in adult patients: A clinical case

https://doi.org/10.21518/ms2024-445

Abstract

The complexity of the differential diagnosis of tuberculosis is due to a combination of factors that lead to diagnostic difficulties and errors. At the forefront of this variability are: the similarity of the clinical and radiological picture of lung diseases with the absence of pathognomonic signs; the pathomorphosis and variability of clinical manifestations of lung diseases, where there is often a diversity of clinical variants of the same nosology. Some diseases with no established etiology (such as sarcoidosis and obliterative bronchiolitis) often mimic tuberculosis. At the current stage, the arsenal of tools that allows for the timely detection and diagnosis of the etiology of pathological changes in the lungs includes a recombinant tuberculosis allergen test (ATR) — the Diaskintest® preparation. Immunodiagnostics plays a leading role in establishing the presumed diagnosis of tuberculosis. This method allows for effective screening not only for active tuberculosis but also for latent tuberculosis infection in individuals with non-tuberculous lesions of the chest organs. Thus, Diaskintest® successfully addresses the issues of detection and differential diagnosis in real clinical practice within diagnostic algorithms for excluding tuberculosis. The article presents a clinical observation of newly diagnosed pulmonary tuberculosis in a 30-year-old man. A distinctive feature of this case is that, in the absence of detection of the tuberculosis pathogen in the early stages of the disease, it was the positive result of the Diaskintest that guided the diagnostic search. As further examination results showed, the probable diagnosis established based on the positive ATR test completely matched the verified diagnosis of tuberculosis. The use of the ATR test allowed for a reduction in the diagnostic pause interval and the timely initiation of appropriate therapy for the patient, even with a negative microscopy result during the differential diagnosis stage.

About the Authors

M. N. Kondakova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Marina N. Kondakova - Professor, Department of Phthisiopulmonology and Thoracic Surgery, North-Western State Medical University named after I.I. Mechnikov.

41, Kirochnaya St., St Petersburg, 191015



R. G. Kovaleva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Raisa G. Kovaleva - Associate Professor, Department of Phthisiopulmonology and Thoracic Surgery, North-Western State Medical University named after I.I. Mechnikov.

41, Kirochnaya St., St Petersburg, 191015



A. V. Elkin
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Alexey V. Elkin - Head of the Department of Phthisiopulmonology and Thoracic Surgery, North-Western State Medical University named after I.I. Mechnikov.

41, Kirochnaya St., St Petersburg, 191015



A. A. Kudryavtseva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Anastasia A. Kudryavtseva - Student, North-Western State Medical University named after I.I. Mechnikov.

41, Kirochnaya St., St Petersburg, 191015



L. O. Smirnova
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Lyubov O. Smirnova - Student, North-Western State Medical University named after I.I. Mechnikov.

41, Kirochnaya St., St Petersburg, 191015



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Review

For citations:


Kondakova MN, Kovaleva RG, Elkin AV, Kudryavtseva AA, Smirnova LO. The role of Diaskintest in detecting tuberculosis in adult patients: A clinical case. Meditsinskiy sovet = Medical Council. 2024;(20):147-152. (In Russ.) https://doi.org/10.21518/ms2024-445

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