Intoducere. Pilonii strategiei DOTS (Directly Observed Treatment Short Course Chemotherapy) aplicate în controlul TB, reprezintă depistarea a 70% din cazurile noi prin microscopia sputei şi atingerea ratei succesului terapeutic de 85%. Drept consecinţă a tergiversării depistării cazurilor noi a crescut ponderea formelor cu expresivitate clinică severă. Scopul lucrării. Evaluarea condiţiilor exogene favorizante ale evoluţiei severe a tuberculozei pulmonare. Material şi metode. Nouăzeci şi cinci de bolnavi de tuberculoză pulmonară infiltrativă cu evoluţie severă, apreciată prin stare generală gravă 51 (53,69%) şi foarte gravă 43 (45,26%), infiltrat pulmonar specific extins (afectând mai mult de 3 segmente) în toate cazurile, dispnee mMRC gr. III – 34 (35,79%) cazuri şi gr. IV – 17 (17,89%) cazuri, SaO2=84% în aerul ambiant, au fost investigaţi conform PCN-123 „Tuberculoza la adult”. Rezultate. Raport bărbaţi/femei = 3/1, vârsta medie 42,5 de ani, studii de şcolarizare incompletă – 54 (56,84%) cazuri, condițiile de trai nesatisfăcătoare – 79 (83,16%) cazuri, vagabondajul – 7 (7,36%) cazuri, migraţia – 14 (14,74%) cazuri, fumatul activ – 87 (91,58%) pacienţi, consumul cronic de alcool – la 60 (63,16%) de cazuri, apartenenţa la focarul de TB – 52 (54,74%) de cazuri. Concluzii. Condiţiile biologice (vârsta tânără, sexul masculin), factorii de risc sociali (nivel de şcolarizare joasă, standard redus de viaţă, migraţia, vagabondajul, deprinderile social-condiţionate, nocive), apartenenţa la focarul de tuberculoză, au contribuit în calitate de condiţii exogene în dezvoltarea evoluţiei severe a tuberculozei pulmonare.

Introduction. DOTS (Directly Observed Treatment Short Course Chemotherapy) TB control actions consist in the achievement of 70% detectional rate through sputum microscopy and 85% of therapeutic success rate. Latent detection of new pulmonary tuberculosis cases increased the rate of severe clinical forms. Objective of the study. Consists in the assessment of some exogenous conditions promoting the severe evolution of pulmonary tuberculosis. Material and methods. Ninety-five new pulmonary infiltrative cases with severe evolution appreciated aspoor general state in 51 (53,69%) cases and extremely poor general condition in 43 (45,26%) cases, extensive specific lung infiltration (affecting more than 3 segments) in all of cases, dispnea mMRC of 3rd degree – 34 (3579%) cases, 4th degree at 17 (17.89%) cases, SaO2=84% in air were investigated according to the NTP-123 "Tuberculosis in adults". Results. The male/female ratio = 3/1, mean age 42.5 years, incomplete scholar studies – 54 (56.84%) cases, poor life conditions stated in 79 (83.16%) cases, vagrancy – 7 (7.36%) cases, migration – 14 (14.74%) cases, active smoking – 87 (91.58±2.85%) cases, chronic alcohol consumption – 60 (63.16%) cases, belonging to a TB cluster – 52 (54.74%) cases. Conclusions. Biological condition (young age, male sex), social risk factors (reduced educational status, low life level conditions), vagrancy, migration, active smoking, chronic alcohol consumption, apartenence to TB cluster contributed as exogenous conditions favorising severe evolution of pulmonary tuberculosis.