Predictors of pulmonary involvement in patients with extra-pulmonary tuberculosis
Open Access
- 1 January 2012
- journal article
- research article
- Published by Medknow in Journal of Family and Community Medicine
- Vol. 19 (2), 88-92
- https://doi.org/10.4103/2230-8229.98287
Abstract
Objectives: The aim of this study is to assess the value of chest radiographs (CXRs) and sputum examinations in detecting pulmonary involvement of tuberculosis (TB) in patients with extra-pulmonary tuberculosis (EPTB). Materials and Methods: A retrospective analysis was performed among 248 EPTB patients with culture-proven diagnosis of tuberculosis seen between January 2001 and December 2007 at a tertiary teaching hospital, Riyadh, Saudi Arabia. Demographics, clinical, laboratory and radiological findings were reviewed and assessed. This study was approved by the hospital ethics and research committee. Results: One hundred twenty five of 233 EPTB patients (53.6%) had abnormal CXR findings. There was a significant difference in the occurrence of positive sputum culture results between patients with abnormal CXR findings (30/57) and those with normal CXR findings (4/17) (P = 0.04). Of 17 HIV-negative/unknown HIV-status EPTB patients with normal CXR results, 4 patients (23.5%) had positive sputum culture results. Intrathoracic lymphadenopathy (P < 0.001), pleural TB (P < 0. 001) and disseminated TB (P = 0.004) were associated with an increased risk of abnormal CXR findings. Patients with cough (52.9%), weight loss (41.2%) and night sweats (26.5%) are more likely to have positive sputum culture results. Conclusion: CXR findings are predictive of positive sputum culture results. However, the rate of normal CXR among EPTB patients with positive sputum culture results was relatively high. Therefore, respiratory specimen cultures should be obtained in TB suspects with a normal CXR to identify potentially infectious cases of TB.Keywords
This publication has 17 references indexed in Scilit:
- Tuberculosis Transmission by Patients with Smear‐Negative Pulmonary Tuberculosis in a Large Cohort in The NetherlandsClinical Infectious Diseases, 2008
- Normal chest radiography in pulmonary tuberculosis: implications for obtaining respiratory specimen cultures.2008
- The role and performance of chest X-ray for the diagnosis of tuberculosis: A cost-effectiveness analysis in Nairobi, KenyaBMC Infectious Diseases, 2005
- Clinical diagnosis of smear-negative pulmonary tuberculosis in low-income countries: the current evidenceThe Lancet Infectious Diseases, 2003
- Pulmonary Tuberculosis in HIV-Infected Patients Presenting with Normal Chest Radiograph and Negative Sputum SmearInfection, 2002
- Phthisiology at the Dawn of the New CenturySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2000
- Diagnostic Standards and Classification of Tuberculosis in Adults and ChildrenAmerican Journal of Respiratory and Critical Care Medicine, 2000
- The Validity of Medical History, Classic Symptoms, and Chest Radiographs in Predicting Pulmonary TuberculosisSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 1999
- Tuberculosis control: many cases found transmitted despite negative result on standard test.1999
- Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilliThe Lancet, 1999