Stojkovic Andjelka, Ilic Irena, Kostic Andrijana, Dajic Katerina, Raskovic Zorica, Nestorovic Jelena, Ilic Milena
University Clinical Center Clinic of Pediatrics Kragujevac Serbia, 34000 Kragujevac, Serbia.
University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Pediatrics, 34000 Kragujevac, Serbia.
Diagnostics (Basel). 2023 Aug 31;13(17):2826. doi: 10.3390/diagnostics13172826.
When hypostatic pneumonia is present at the same time as COVID-19 pneumonia, the clinical course is almost always prolonged (prolonged-COVID-19) due to persistent inflammation, long-term anti-inflammatory syndrome, followed by immune exhaustion, i.e., by immunosuppression and catabolic syndrome. In the immunosuppression phase, viral reactivation can be accompanied by a secondary infection, which, in this case, is pulmonary tuberculosis. Pulmonary tuberculosis in post-COVID-19 patients and in patients with spastic quadriplegic cerebral palsy does not have a typical clinical course nor laboratory, radiological, immunological, microbiological, or fiberbronchoscopic pathohistological confirmation. Due to this, the treatment of pulmonary tuberculosis was not carried out on time, postponed after the unsuccessful treatment of sepsis, post-COVID-19, and other accompanying viral (adenovirus, RSV) and bacterial (streptococcus viridans) infections. The treatment of pulmonary tuberculosis was possible only "ex juvantibus" (trial) post-COVID-19. It becomes imperative to search for a new, more precise and reliable diagnostic test for the detection of tuberculosis bacillus.
当坠积性肺炎与新型冠状病毒肺炎同时存在时，由于持续炎症、长期抗炎综合征，随后出现免疫耗竭，即免疫抑制和分解代谢综合征，临床病程几乎总是延长（长病程新型冠状病毒肺炎）。在免疫抑制阶段，病毒再激活可伴有继发感染，在这种情况下为肺结核。新型冠状病毒肺炎康复后患者及痉挛性四肢瘫脑瘫患者的肺结核没有典型的临床病程，也没有实验室、放射学、免疫学、微生物学或纤维支气管镜病理组织学确诊依据。因此，肺结核治疗未及时开展，在脓毒症、新型冠状病毒肺炎康复后及其他伴随的病毒（腺病毒、呼吸道合胞病毒）和细菌（草绿色链球菌）感染治疗失败后被推迟。肺结核治疗仅在新型冠状病毒肺炎康复后“根据经验”（试行）进行。寻找一种新的、更精确可靠的检测结核杆菌的诊断试验变得势在必行。
