Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciences0869-60472414-3545"Paediatrician" Publishers LLC24110.15690/vramn.v67i11.466OPTIMISATION OF DIAGNOSTICS AND DIFFERENTIAL DIAGNOSTICS DISSEMINATED PULMONARY TUBERCULOSISDemikhovaO. V.demikhova@mail.ruKarpinaN. L.natalya-karpina@rambler.ruLepekhaL. N.lep3@yandex.ruBagirovM. A.cniit@cniitramn.ruAmansakhedovR. B.rasul.amansahedov@mail.ruCentral Tuberculosis Research Institute of Russian Academy Medical Sciences, Moscow, Russian Federation101120126711152107082015Copyright © 2012, "Paediatrician" Publishers LLC2012<p><em>One of the reasons of dramatic situation with tuberculosis in Russia is untimely diagnostics of tuberculosis. The aim of the study was to identify the causes of diagnostic mistakes when we deal with disseminated pulmonary tuberculosis at current stage and to modernize the diagnostic process. The analysis of the diagnostic activity of the consultative diagnostic center of Central Tuberculosis Research Institute of Russian Academy Medical Sciences for 2011 was performed with special attention on the results of the survey of 505 patients with pulmonary dissemination. The frequency of discrepancies of disseminated pulmonary tuberculosis diagnostics was 96,1%. Based on the studies carried out the main causes diagnostic mistakes in patients with disseminated pulmonary tuberculosis were determined. New directions of improving of tuberculosis diagnostics were developed: overall high-technology examination of patient, adherence to the diagnostic procedure, developed by consultative diagnostic center of Central Tuberculosis Research Institute(CTRI), timely performing fiber-optic bronchoscopy with complex biopsy and diagnostic surgery procedures, further training of primary health care doctors. Implementation of proposed activities will significantly (by 3–5 times) reduce the time for diagnostics of respiratory system disease.</em></p><p> </p>diagnosticsdifferential diagnostics of disseminated pulmonary tuberculosisfrequency of discrepancies of diagnosesmistakes in diagnosticsways of modernizationдиагностикадифференциальная диагностика диссеминированного туберкулеза легкихчастота расхождения диагнозовошибки диагностикипути модернизации[1. Tuberkulez v Rossiiskoi Federatsii, 2010. Analiticheskii obzor statisticheskikh pokazatelei, ispol'zuemykh v Rossiiskoi Federatsii. [Tuberculosis in the Russian Federation, 2010. Analytical review of statistical indicators used in the Russian Federation] Moscow, 2011. 280 p.][2. Tyurin I.E. Komp'yuternaya tomografiya organov grudnoi polosti [Computed tomography of the chest cavity]. St. Petersburg, ELBI-SPb, 2005. p. 371.][3. Babaeva I.Yu., Demikhova O.V., Kravchenko A.V. Disseminirovannyi tuberkulez legkikh u bol'nykh VICh-infektsiei. Izd. pervoe [Disseminated pulmonary tuberculosis in patients with HIV infection. Ed. first]. Moscow, N''Yu TERRA, 2010. 164 p.][4. Il'kovich M.M. Zabolevaniya organov dykhaniya [Respiratory diseases]. St. Petersburg, Normedizdat, 1998. p. 185–198.][5. Erokhin V.V., Gedymin L.E., Lepekha L.N., Dvorakovskaya I.V. Interstitsial'nye bolezni legkikh. Kletochnaya biologiya legkikh v norme i pri patologii: Ruk-vo dlya vrachei. Pod red. V.V. Erokhina, L.K. Romanovoi [Interstitial lung disease. Cell biology of lung in health and disease: Manual for physicians. Edited by V.V. Erokhin, L.K. Romanova]. Moscow, Meditsina, 2000. p. 385–410.][6. Disseminirovannye zabolevaniya legkikh. Pod red. M.M. Il'kovicha [Disseminated pulmonary disease. Edited by M.M. Il'kovich]. Moscow, GEOTAR-Media, 2011. 480 p.][7. Mishin V.Yu., Strelis A.K., Chukanov V.I. et al. Lektsii po ftiziopul'monologii [Lectures on Phthisiopulmonology]. Moscow, MIA, 2006. 560 p.]