The groups of «risk» in relation to extrapulmonary tuberculosis primarily include: patients with active forms of tuberculosis of the respiratory organs, especially bacterial excretors, persons who previously had active tuberculosis of the respiratory organs, who are in contact with bacterial excretors; children and adolescents with a tuberculin test turn.
The risk group for tuberculosis of bones and joints includes patients with long-term arthritis, polyarthritis, osteomyelitis of epiphyseal localization, including complicated fistulas. Osteochondrosis and deformities of the spine, radiculitis, as well as persistent pain in the back, joints and gait disorders. Such patients undergo LFF, a DiaskinTest, X-ray of the joints or spine in two projections, and examination of the discharge from the fistulas and punctate on the MBT.
Patients are monitored until recovery or establishment of the etiology of the disease. Observation occurs annually.
The risk group for tuberculosis of the genitourinary system includes patients with chronic pyelonephritis, chronic cystitis, calculous pyelonephritis, urolithiasis. With attacks of renal colic, with hematuria and hypertension of unknown etiology, with radiculitis, chronic orchiepididymitis and epididymitis.
Examination: LFF, DiaskinTest, general urinalysis, multiple urine cultures for MBT and plain radiography of the abdominal organs. Patients are observed until recovery or establishment of the etiology of the disease. Observation occurs annually .
The risk group for tuberculosis of the female genital organs includes women with long-term inflammatory diseases of the female genital organs, not amenable to nonspecific therapy, with primary and secondary infertility, persistent menstrual dysfunction.
Examination: LFF, DiaskinTest, plain radiography of the abdominal organs, hysterosalpingography, smear culture from the vagina, cervical canal and urethra on the MBT.
Patients are observed until recovery or establishment of the etiology of the disease. Observation occurs annually.
The risk group for eye tuberculosis should include patients with chronic recurrent inflammatory eye diseases: iritis, iridocyclitis, choroiditis. Diseases of the choroid involving other membranes: keratoconjunctivitis, sclerouveitis, chorioretinitis, etc.
Complete examination by an ophthalmologist with the exclusion of other etiological factors.
Examination by a phthisiatrician to detect active tuberculosis or residual changes in tuberculosis in the lungs and other organs and systems, LFF 1 time per year, DiaskinTest.
The risk group for skin tuberculosis should include patients with infectious and parasitic skin diseases (tuberculous form of cutaneous leishmaniasis, chromoblastomycosis, actinomycosis, sporotrichosis, chronic nonspecific ulcerative or vegetative pyoderma, chronic acne, infectious-allergic vasculitis of the skin with papulonecrotic or nodular rashes, chronic discoid lupus erythematosus, small and large nodular forms of skin sarcoidosis, infiltrative lesions of the mouth and nasopharynx, migrating odontogenic granulomas of the face, phlebitis and trophic ulcers in young and middle-aged women).
Examination: LFF, DiaskinTest, diagnostic biopsy of the skin or the edge of the ulcer for histological and bacteriological examination. Patients are observed until recovery or establishment of the etiology of the disease. Observation occurs annually.
The risk group for tuberculosis of peripheral lymph nodes should include patients with chronic inflammatory diseases of the lymph nodes, including those with long-term non-healing fistulas. Enlargement of lymph nodes of unknown etiology — cervical, axillary, inguinal and other localizations. Such patients undergo LFF, blood for the Wasserman reaction, DiaskinTest, diagnostic biopsy of the lymph node for histological and bacteriological examination, examination of discharge from fistulas and punctate for MBT.
The risk group for tuberculosis of the abdominal cavity includes patients with chronic cholecystitis, appendicitis, colitis, peptic ulcer of the stomach and duodenum, partial intestinal obstruction, tumor-like formations in the lesser pelvis, an atypical picture of an acute abdomen.
Examination: LFF, DiaskinTest, general radiography of the abdominal organs, analysis of gastric juice, puncture of the abdominal cavity with the study of exudate for cytosis and MBT.
Patients are observed until recovery or establishment of the etiology of the disease. Stationary examination in acute abdomen and obstruction. Observation occurs annually.
The risk group for tuberculous meningitis includes patients with meningeal symptoms, with progressive headaches.
It is necessary to do an X-ray of the lungs and skull, DiaskinTest, examination of the fundus, lumbar puncture. Patients are observed until recovery or establishment of the etiology of the disease. Urgent inpatient examination. Observation of a phthisiatrician, neuropathologist, infectious disease specialist.
Children, adolescents and adults in the above groups are subject to an annual TB screening. It is necessary to perform a diagnostic minimum and consult a phthisiatrician before establishing a diagnosis.