Introducere. Există criterii standardizate de diferenţiere ale TB pulmonare infiltrative (TBPI).
Scopul lucrării. Identificarea particularităţilor de diferenţiere ale TBPI de infiltratele pulmonare de etiologie nespecifică.
Material și metode. Studiu retrospectiv asupra particularităţilor generale, microbiologice şi radiologice a 65 pacienţi cu TBPI (lotul 1) şi 44 bolnavi de pneumonie comunitară (lotul 2).
Rezultate. Distribuția conform sexului a determinat predominarea bărbaţilor 48 (74%) vs 17 (26%) femei în lotul 1 şi 31 (69%) vs. 14 (31%) în lotul 2. Comorbidităţi au avut 44 (100%) lotul 1 vs. 35 (54%) lotul 2. În lotul 1 microscopia sputei a fost positivă pentru BAAR la 16 (24%), cultura pentru MTB 18 (27%) şi GeneXpert MTB/Rif 27 (41%). În lotul 2 toate examinările microbiologice au fost negative. La examenul radiologic s-a constat opacităţi infiltrative la 65 (100%) lotul 1 vs. 19 (43%) lotul 2, afectarea ambilor plămîni 14 (21%) lotul 1 vs. 7 (16%) lotul 2, afectarea lobilor superiori 45 (69%) lotul 1 vs. 7 (16%) lotul 2, a lobilor mediu şi inferior 20 (31%) lotul 1 vs. 20 (45%) lotul 2, destrucţii pulmonare la 31 (47%) din lotul 1 vs. 14 (32%) lotul 2, opacităţi micronodulare 32 (49%) lotul 1 vs. 3 (7%) lotul 2, pleurezie la 5 (8%) din lotul 1 vs. 21 (48%) din lotul 2, aspect reticulonodular 9 (20%) doar în lotul 2.
Concluzii. Criteriile de diferenţiere ale TBPI de infiltratele nespecifice sunt destrucţia pulmonară, microopacităţile de diseminaţie, afectarea ambilor plămîni şi localizarea în lobii superiori. Sensibilitatea joasă a metodelor microbiologice a determinat dificultatea diagnosticului diferenţial la 2/3 din cazuri.

Introduction. There were standardised differential criteria of pulmonary infiltrative TB (PITB) with infiltrative opacities of the non-specific ethiology.
Objective of the study. was to assess the general, microbiological and radiological peculiarities that differentiate PITB from the non-specific ethiology infiltrates.
Material and methods. Was performed a retrospective study targeting general, microbiological and radiological pecualiarities of 65 patients with PITB (group 1) and 44 patients with community-acquired pneumonia (group 2).
Results. The distribution according to the sex identified the predominance of men 48 (74%) vs. 17 (26%) women in group 1 and 31 (69%) vs. 14 (31%) in group 2. Comorbidities had 44 (100%) in group 1 vs. 35 (54%) group 2. In group 1 were positive for AFB microscopy 16 (24%), culture for MTB 18 (27%) and GeneXpert MTB/Rif 27 (41%) cases. In group 2 all microbiological exams were negative. Chest X ray revealed infiltrative opacitites at 65 (100%) vs. 19 (43%), both lungs were involved at 14 (21%) vs. 7 (16%), superior lobes were affected at 45 (69%) vs. 7 (16%), medium and inferior lobes at 20 (31%) vs. 20 (45%), lung destructions were revealed at 31 (47%) vs. 14 (32%), micronodular opacities at 32 (49%) vs. 3 (7%), pleuresy at 5 (8%) vs. 21 (48%), reticulonodular pattern only in 9 (20%) patients from the group 2.
Conclusions. Differential criteria between PITB and non-specifiques infiltrates are pulmonary destructions, disseminative microopacities, both lung involvement and the localization in superior lobes. Low sensibility of microbiological methods determined the differential difficulties in 2/3 of cases.