Radiographic spectrum of adult pulmonary tuberculosis in a developed country

Wilcke, Jon Torgny; Askgaard, Dorthe; Jensen, Birgitte Nybo; Døssing, M.

doi:10.1016/s0954-6111(98)90297-9

Cited by 30 publications

(31 citation statements)

References 16 publications

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“…Most of the study patients with culture-proven pulmonary TB had typical abnormalities on chest radiographs, which is consistent with the literature [9,28,29]. Atypical patterns are often found in patients with diabetes or in renal transplant recipients [30].…”

Section: Discussionsupporting

confidence: 89%

Value of smear and PCR in bronchoalveolar lavage fluid in culture positive pulmonary tuberculosis

Tueller

Chhajed²,

Buitrago-Téllez³

et al. 2005

Eur Respir J

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At present, further investigations are needed in patients with suspected pulmonary tuberculosis (TB) and either negative sputum smear or without sputum. The aim of the present study was to analyse the yield of bronchoalveolar lavage fluid (BALF) smear and PCR in patients with confirmed pulmonary TB.Patients with a positive culture for Mycobacterium tuberculosis complex in sputum or BALF were analysed over 5 yrs.In total, 90 out of 230 (39%) patients with culture-positive pulmonary TB had a positive sputum smear, and 120 patients underwent bronchoscopy. BALF smear was positive in 56 (47%), BALF PCR in 93 (78%) patients, and BALF smear and/or PCR was positive in 83%. In total, 71 patients who underwent bronchoscopy and had complete clinical records were further analysed. BALF (smear or Mycobacterium tuberculosis complex-PCR) allowed a rapid diagnosis in 10 (59%) out of 17 patients who had a negative sputum smear, and 49 (91%) out of 54 patients without sputum production. Of these 71 patients, 12 (17%) were only culture positive. Rapid diagnosis of pulmonary TB by smear and/or PCR was made in 190 out of 210 patients (90%) in sputum or BALF.In conclusion, combined use of bronchoalveolar lavage fluid smear and Mycobacterium tuberculosis complex-PCR has a good diagnostic yield in patients with sputum smear-negative tuberculosis or without sputum production.

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Section: Discussionsupporting

confidence: 89%

Value of smear and PCR in bronchoalveolar lavage fluid in culture positive pulmonary tuberculosis

Tueller

Chhajed²,

Buitrago-Téllez³

et al. 2005

Eur Respir J

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“…The presence of cavitary disease on chest radiograph at the time of diagnosis also is a strong predictor of relapse after treatment (9)(10)(11)(12)(13)(14). The proportion of adults with newly diagnosed TB who have cavitary disease ranges from 40 to 87% (15)(16)(17). Patients …”

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confidence: 99%

Shortening Treatment in Adults with Noncavitary Tuberculosis and 2-Month Culture Conversion

Johnson¹,

Hadad²,

Dietze³

et al. 2009

Am J Respir Crit Care Med

131

108

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Rationale: Cavitary disease and delayed culture conversion have been associated with relapse. Combining patient characteristics and measures of bacteriologic response might allow treatment shortening with current drugs in some patients. Objectives: To assess whether treatment could be shortened from 6 to 4 months in patients with noncavitary tuberculosis whose sputum cultures converted to negative after 2 months. Methods: This study was a randomized, open-label equivalence trial. HIV-uninfected adults with noncavitary tuberculosis were treated daily with isoniazid, rifampin, pyrazinamide, and ethambutol for 2 months, followed by 2 months of isoniazid and rifampin. After 4 months, patients with drug-susceptible TB whose sputum cultures on solid media were negative after 8 weeks of treatment were randomly assigned to continue treatment for 2 more months or to stop treatment. Patients were followed for relapse for 30 months after beginning treatment. Measurements and Main Results: Enrollment was stopped by the safety monitoring committee after 394 patients were enrolled due to apparent increased risk for relapse in the 4-month arm. A total of 370 patients were eligible for per protocol analysis. Thirteen patients in the 4-month arm relapsed, compared with three subjects in the 6-month arm (7.0 vs. 1.6%; risk difference, 0.054; 95% confidence interval with Hauck-Anderson correction, 0.01-0.10). Conclusion: Shortening treatment from 6 to 4 months in adults with noncavitary disease and culture conversion after 2 months using current drugs resulted in a greater relapse rate. The combination of noncavitary disease and 2-month culture conversion was insufficient to identify patients with decreased risk for relapse.

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“…The proportion of adults with pulmonary tuberculosis (TB) who have cavitary disease at the time of diagnosis ranges from 40 to 87% (1,9,17). Several studies using qualitative smears and cultures have shown that patients with cavitary pulmonary TB have higher bacterial loads in their sputum (3,9,10,12,15).…”

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confidence: 99%

Cavitary Disease and Quantitative Sputum Bacillary Load in Cases of Pulmonary Tuberculosis

et al. 2007

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Radiographic spectrum of adult pulmonary tuberculosis in a developed country

Cited by 30 publications

References 16 publications

Value of smear and PCR in bronchoalveolar lavage fluid in culture positive pulmonary tuberculosis

Value of smear and PCR in bronchoalveolar lavage fluid in culture positive pulmonary tuberculosis

Shortening Treatment in Adults with Noncavitary Tuberculosis and 2-Month Culture Conversion

Cavitary Disease and Quantitative Sputum Bacillary Load in Cases of Pulmonary Tuberculosis

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