Imaging of Pulmonary Post-Tuberculosis Sequelae

Abstract

Worldwide, tuberculosis (TB) is one of the top 10 causes of death, and the leading cause from a single infectious agent. Pakistan has an overwhelming burden of TB and it is a major health hazard for the majority of the rural population. The lung continues to be the most common site of involvement and even after completion of treatment residual changes remain which may affect quality of life.Complications of TB after treatment completion can often be misinterpreted for other active diseases so it is important to recognize and understand the radiologic manifestations of the thoracic sequelae. Post TB sequelae can be categorized into parenchymal, airway disease, pleural/chest wall, vascular and mediastinal. These residual changes can be minor however, some can be debilitating and even fatal.The purpose of this pictorial review is to show the spectrum of residual changes seen on chest radiography and/or computed tomography that persist after treatment completion and bacteriological cure.
 doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1722
 How to cite this:Khan R, Malik NI, Razaque A. Imaging of Pulmonary Post-Tuberculosis Sequelae . Pak J Med Sci. Special Supplement ICON 2020. 2020;36(1):S75-S82. doi: https://doi.org/10.12669/pjms.36.ICON-Suppl.1722
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Post-tuberculosis chronic pulmonary aspergillosis: An emerging public health concern

“…These symptoms are clinically indistinguishable from those of PTB. Furthermore, progressive cavitation, fibrosis, and pleural thickening seen in confirmed CPA are similar to radiological features observed in PTB, PTBLD, and in relapse of PTB [3,8,14]. PTB constitutes over 85% of the global TB burden; however, only 65% of these patients are bacteriologically confirmed cases [23].…”

“…Pulmonary TB (PTB), the most common form of TB, causes extensive structural lung changes in more than two-thirds of the patients that persists after treatment despite microbiological cure of the active disease [8][9][10]. These residual changes can be categorized into parenchymal, airway disease, pleural/chest wall, vascular, and mediastinal pathologies, collectively referred to as post-TB lung disease (PTBLD) [3,8]. Infectious complications, including chronic pulmonary aspergillosis (CPA), is common in PTBLD [3,4].…”

Chronic Pulmonary Aspergillosis: Literature Review and Demonstration of Own Observations

“…Изучение компьютерных томограмм пациентов, прошедших лечение от туберкулеза, показало наличие сохраняющихся полостей и бронхоэктазов как наиболее часто встречаемых последствий (рис. 2) [23,24].…”

Modulação autonômica cardíaca em pacientes com sequela de tuberculose pulmonar tratada

“…Estas sequelas foram vistas em um estudo onde 91% apresentavam alterações parenquimatosas e pleurais após tratamento e em 9% havia resolu ção completa da doença (Ali et al, 2018). Em exames de imagem na sequela de TB são visualizados cavidades de paredes finas com 1cm de espessura, podendo ser lisa de difícil distinção, de cavidades verdadeiras, de bolhas, cistos ou pneumatoceles; aspergiloma é uma massa fúngica encontrada em cavidades tuberculosas residuais após o tratamento de TB; bronquiectasias causada pela destruição e fibrose do parênquima pulmonar com dilatação brônquica secundária e irreversível, altamente sugestiva de TB quando encontrada no lobo superior do pulmão; fibrotórax associado a distúrbio ventilatório restritivo e indica inatividade da TB e, fístula bronco pleural (Khan et al, 2020).…”

“…Alterações sugestivas de inatividade da doença ou sequelas de TB são descritas como cavidades de paredes finas (também encontradas na TB ativa), aspergiloma, bronquiectasia, fibrotórax e fístula broncopleural. E, o carcinoma broncogênico pode ser encontrado na cicatriz tuberculosa quando a TB latente é ativada (Khan et al, 2020). Os sintomas respiratórios persistentes limitam as atividades de vida diária e reduzem a qualidade de vida .…”