Pattern of chest radiographic abnormalities and co-morbidities in newly detected sputum positive pulmonary tuberculosis cases

Abstract

Background: Tuberculosis (TB) is an airborne communicable disease which one of the leading causes of morbidity and deaths worldwide (ranking above AIDS).1 Probability of detecting AFB on sputum is greatly associated by the radiological findings.8 Because of the apparent widespread difficulty in recognizing the radiographic manifestations of pulmonary tuberculosis, it will be beneficial to review the spectrum of chest x-ray abnormalities in sputum positive tuberculosis patients. Aim: To study clinical features, radiological features and comorbidities among newly detected sputum positive pulmonary tuberculosis patients. Settings and design: The hospital based cross-sectional study was conducted from the year 2016-2018 at a tertiary care teaching hospital in Mangalore. Methodology : Newly diagnosed smear positive pulmonary tuberculosis aged between 18-70 years attending OPD/IPD of Department of Respiratory Medicine, who fulfilled study eligibility criteria were included. Comprehensive clinical assessment was conducted and information regarding socio-demographic profile, comorbidities were noted. Chest x-ray PA view was performed for all patients. Statistical A nalysis: Data was analyzed in SPSS V:20. Data is presented in frequency, percentages. Chisquare, was applied to test significance of association. Results: A total of 563 (309 elderly and 254 adult) patients participated in study. Male predominance was noted (64.7%). Cough (94.1%) and expectoration (83.8%) were the most common symptoms. High bacillary load (3+) and bilateral lungs involvement were predominant among elderly patients (75.6%). Cavitary lesions were predominant among adults. Infiltration (39.6%), cavitary lesions (37.7%) and consolidation (37.5%) were most common lesions seen in chest x-ray. Cavitary lesions were found in higher percentage among patients with higher bacterial load of 2+and 3+ (36.8% and 33.0% respectively). Bilateral lesions were associated with TB patients with diabetes mellitus (69.7%). Conclusions: Infiltration and cavitary lesions among newly diagnosed sputum positive pulmonary tuberculosis patients. Lower zone involvement among female group and Bilateral involvement and atypical lesions among PTB patients with diabetes mellitus were noted. Higher rates of co-morbid conditions like diabetes mellitus, cardiovascular disorders and COPD among elderly TB patients, higher bacillary load and atypical findings among diabetics warrant need for active screening.

Clinicoradiological Profile of Patients Having Drug-Sensitive Pulmonary Tuberculosis With and Without Diabetes Mellitus in a Tertiary Care Hospital in Ahmedabad, Gujarat, India

“…Our study reported that lower zone involvement in chest X-ray was significantly higher (Fisher’s exact test p-value = 0.0079) in pulmonary TB with DM (17/20, 85%) compared to pulmonary TB without DM group (8/20, 40%). Multiple previous studies showed the same atypical finding in chest X-rays [ 2 , 8 - 13 , 23 , 24 ]. However, several other studies showed similar radiological findings in both groups [ 14 - 17 , 25 ].…”