Radiographic manifestations of culture-positive pulmonary tuberculosis: cavitary or non-cavitary?

Int J Tuberc Lung Dis. 2009 Mar;13(3):367-70.

Abstract

Objective: To examine the radiographic pattern of patients with pulmonary tuberculosis (PTB) in Saudi Arabia and the relation of these findings to demographic and microbiological data.

Design: A retrospective hospital-based series of patients with culture-positive PTB.

Results: Among 168 cases of culture-positive PTB identified, 97 (57.7%) were males and 71 females (42.3%); 136 (81%) were Saudis and 19% were non-Saudis. The mean age was 52.3 +/- 19.2 years: nine (5.4%) were children aged <or=18 years and 64 (38.1%) were adults aged >60 years. Overall, 121 (78%) had upper lobe infiltrates, 35 (19.7%) had cavitary lesions and 33 (19.6%) had both upper lobe infiltrate and cavitation. Lymphadenopathy and pleural effusion were each present in 11.3% of the patients. Patients aged >60 years were less likely to have upper lobe infiltrate (38/64, 59.4%) compared to children (7/9, 77.8%) and adults aged 19-60 years (76/95, 80%, P = 0.001). Diabetes mellitus was documented in 57/135 (42.2%) patients. There was no difference in the presence of upper lobe infiltrate and the presence of cavitation in patients with and without diabetes mellitus.

Conclusion: Cavitary or upper lobe infiltrate remains a common presentation of PTB. As patients aged >60 years often present with no cavitation and without upper lobe infiltrate, it is important to keep in mind the possibility of tuberculosis in this group of patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use
  • Child
  • Comorbidity
  • Diabetes Mellitus / epidemiology
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Isoniazid / pharmacology
  • Isoniazid / therapeutic use
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects
  • Radiography
  • Retrospective Studies
  • Sputum / microbiology*
  • Tuberculosis, Pulmonary / diagnostic imaging*
  • Tuberculosis, Pulmonary / epidemiology
  • Young Adult

Substances

  • Antitubercular Agents
  • Isoniazid