Adult-onset pulmonary tuberculosis.

Abstract

Medical records and radiographs of 103 adults with primary tuberculosis were reviewed. The shift toward delayed presentation appears to be related to decreasing childhood exposure and an increasing number of compromised hosts. Compared with classic "childhood" tuberculosis, there is a higher incidence of lower-lobe disease, but infiltrates also commonly involve the upper lobe or upper segments of the lower lobe. Adenopathy, cavitation, and tuberculoma are rare. If a pleural effusion is present and tuberculosis is suspected, pleural biopsy is mandatory. Adult respiratory distress syndrome can be a complication, particularly in miliary tuberculosis, and disseminated intravascular coagulopathy usually follows. A normal chest radiograph or clinical improvement of the patient with bed rest and penicillin does not exclude tuberculosis. Increased awareness of adult-onset tuberculosis on the part of radiologists could lead to a more rapid diagnosis and successful management.

The Radiographic Features of Pulmonary Tuberculosis Observed for the Western Region of Saudi Arabia

“…Pleural effusion is not as common in post-primary PTB as it is in primary disease [1,11], and is more commonly seen in adults than in children [13]. It can occur in more than 40% of the adult patients [1,17]. Pleural effusion may be an isolated finding in PTB (1.8%) [4], and was seen in 0.6% of our cases.…”

“…Such features can mask the true diagnosis and delay treatment. Many of the unusual manifestations may represent the primary form of the disease occurring in the adult population [17]. In the West, it is estimated that 10 to 20% of adult cases of PTB represent primary disease [5,17].…”

“…Many of the unusual manifestations may represent the primary form of the disease occurring in the adult population [17]. In the West, it is estimated that 10 to 20% of adult cases of PTB represent primary disease [5,17]. Pleural effusion is not as common in post-primary PTB as it is in primary disease [1,11], and is more commonly seen in adults than in children [13].…”

“…Isolated lower lobe tuberculosis is an unusual manifestation [4,6,8,18] and is probably seen more frequently in primary PTB [17]. Its reported incidence varies from 1 to 18.3% [4].…”

A study of respiratory distress in patients with bilateral lung opacities admitted in a tertiary care hospital

“…LN enlargement is usually seen in up to 96% of children and 43% adults with primary TB. [1][2][3] Most common sites of nodal involvement are Right paratracheal, hilar, and subcarinal regions, though other sites may also be affected. Bilateral adenopathy occurs in 31% cases.…”