Characteristics of tuberculosis dispensary patients under observation for tuberculosis without confirmed bacterial excretion

Aim: to analyze the clinical, epidemiological, and laboratory characteristics of patients presenting with limited pulmonary damage, who were monitored in tuberculosis care institutions. Patients and Methods: a retrospective study was conducted based on medical record analysis of patients observed for tuberculosis in an antituberculosis dispensary during 2020–2021. Initial chest X-ray findings revealed limited pulmonary damage (involvement of 1–2 segments either unilaterally or bilaterally) in all patients referred for evaluation by a phthisiatrician. The cohort was divided into two groups: the main group (MG, n=95) comprised patients exhibiting positive clinical and radiological changes suggestive of tuberculosis, whereas the comparison group (CG, n=95) included individuals whose diagnosis was confirmed to be of non-tuberculosis origin. Clinical, epidemiological, laboratory, and microbiological data were systematically analyzed. Results: patients in the MG were predominantly of working age, while older males constituted a statistically significant majority in the CG (p=0.000, p=0.003). Both groups were mostly identified during scheduled preventive examinations, although this was observed more frequently in MG patients (74.7% vs. 64.2%, p<0.05). History of contact with a known tuberculosis patient, as well as a positive immune response to the recombinant tuberculosis allergen, were reported with similar frequency in both groups. However, symptoms such as cough (p=0.006) and dyspnea (p=0.000) were more frequently reported in CG patients. Contact with an active tuberculosis case was documented in 9.5% of MG patients and 11.6% of CG patients (p>0.05). DNA of Mycobacterium tuberculosis was identified in 13.7% and 6.3% of MG and CG cases, respectively (p=0.091) Conclusion: the study demonstrated that clinical symptoms suspicious for tuberculosis were similarly common in both groups and could not serve as definitive diagnostic criteria. Furthermore, documented history of contact with tuberculosis patients and the detection of M. tuberculosis DNA in some individuals from both groups necessitated consultation with a phthisiatrician and, in certain cases, a trial of anti-tuberculosis therapy (ex juvantibus). The findings emphasize that patients presenting with confined pulmonary lesions and an absence of pathognomonic features of tuberculosis commonly require invasive diagnostic procedures to establish a definitive diagnosis. Keywords: tuberculosis, diagnosis, diagnostic verification, confirmed diagnosis, tuberculosis dispensary patients, bacterial excretion, non- tuberculous conditions, invasive diagnostics. For citation: Kutuzova D.M., Tyulkova T.E., Tinkova V.V. Characteristics of tuberculosis dispensary patients under observation for tuberculosis without confirmed bacterial excretion. RMJ. 2025;1:2–6. DOI: 10.32364/2225-2282-2025-1-1