Chest X-rays and associated clinical parameters in pulmonary Tubercolosis cases from the National Tubercolosis Program, Mumbai, India (original) (raw)
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eJournal Kedokteran Indonesia, 2018
The objective of this study is to know the relationship between MDR-TB treatment to the changes in diameter and thickness of cavity wall on chest X-ray (CXR) 6 month and 12 months post treatment. This study was conducted in MDR-TB clinic in Kariadi Hospital, Semarang on January 2013-December 2016. We examine cavitary lesions, evaluated with CXR in pulmonary MDR-TB patients before and after 6 and 12 months of treatment course. Subjects who had been diagnosed as pulmonary MDR-TB and had received MDR-TB treatment for at least 12 months were chosen. Subjects characteristics and cavities features i.e. cavity number, diameter and wall thickness from initial and follow-up CXR 6 and 12 months of treatment were retrieved. A total of 43 patients of MDR-TB, consisted of 22 males and 21 females, was recruited. Most of the subjects aged 31-50 year old and presented with single cavity. The cavitary lesions showed significant reduction over 6 and 12 months of follow up based on CXR (p<0.001) for both diameter and wall thickness. Both diameter and wall thickness changed significantly from initial to 6 months (r=-0.87, p<0.001), initial to 12 months (r=-087, p<0.001), and 6 months to 12 months (r=-0.84, p<0.001), respectively. In conclusion, CXR as a useful diagnostic instrument that can be used to evaluate pulmonary TB, in primarily low resource setting.
BMC Medicine, 2018
Background: Chest radiographs are used for diagnosis and severity assessment in tuberculosis (TB). The extent of disease as determined by smear grade and cavitation as a binary measure can predict 2-month smear results, but little has been done to determine whether radiological severity reflects the bacterial burden at diagnosis. Methods: Pre-treatment chest x-rays from 1837 participants with smear-positive pulmonary TB enrolled into the REMoxTB trial (Gillespie et al., N Engl J Med 371:1577-87, 2014) were retrospectively reviewed. Two clinicians blinded to clinical details using the Ralph scoring system performed separate readings. An independent reader reviewed discrepant results for quality assessment and cavity presence. Cavitation presence was plotted against time to positivity (TTP) of sputum liquid cultures (MGIT 960). The Wilcoxon rank sum test was performed to calculate the difference in average TTP for these groups. The average lung field affected was compared to log 10 TTP by linear regression. Baseline markers of disease severity and patient characteristics were added in univariable regression analysis against radiological severity and a multivariable regression model was created to explore their relationship. Results: For 1354 participants, the median TTP was 117 h (4.88 days), being 26 h longer (95% CI 16-30, p < 0.001) in patients without cavitation compared to those with cavitation. The median percentage of lung-field affected was 18.1% (IQR 11.3-28.8%). For every 10-fold increase in TTP, the area of lung field affected decreased by 11.4%. Multivariable models showed that serum albumin decreased significantly as the percentage of lung field area increased in both those with and without cavitation. In addition, BMI and logged TTP had a small but significant effect in those with cavitation and the number of severe TB symptoms in the non-cavitation group also had a small effect, whilst other factors found to be significant on univariable analysis lost this effect in the model. Conclusions: The radiological severity of disease on chest x-ray prior to treatment in smear positive pulmonary TB patients is weakly associated with the bacterial burden. When compared against other variables at diagnosis, this effect is lost in those without cavitation. Radiological severity does reflect the overall disease severity in smear positive pulmonary TB, but we suggest that clinicians should be cautious in over-interpreting the significance of radiological disease extent at diagnosis.
Iranian Journal of Radiology, 2009
Background/Objective: Tuberculosis (TB) is one of the most common worldwide infections, especially in developing countries. Early diagnosis is very important for prevention of the chronic form of the disease and sequel formation. Chest x-ray (CXR) is an easy, feasible, nonexpensive and quick tool for the diagnosis of pulmonary tuberculosis. Patients and Methods: We retrospectively evaluated 200 chest x-rays of secondary pulmonary TB cases in university-affiliated hospitals. These cases were all proved by a positive sputum smear or culture for mycobacterium tuberculosis. Results: In this study, we correlated CXR findings of 100 male and 100 female patients. The peak age of involvement in both groups was 61-80 years. None of the chest x-rays were normal. The main radiographic findings were consolidation-infiltration, fibrosis, pleural effusion, cavitation, pleural thickening and bronchiectasis. Mediastinal lymphadenopathy was detected in 9% of the cases. Pulmonary infiltration with co...
Journal of Natural Science, Biology, and Medicine, 2018
Background: Imaging has a big role in tuberculosis (TB) diagnosis and chest X-ray is preferable because it is available in primary health care and can point out the location, area, and morphology of lesions, such as cavity, consolidation, pleural effusions, and fibrosis. We aimed to compare the chest X-ray findings in multi-drug resistant TB (MDR-TB) and in drug-sensitive TB (DS-TB) cases. Methods: This is a retrospective cross-sectional study which compares chest X-ray findings of two groups of patients, involving 183 DS-TB patients and 183 MDR-TB patients. Radiologic findings that we analyzed were infiltrate, consolidation, cavity, ground glass opacity, fibrosis, bronchiectasis, calcification, node, atelectasis, bullae, emphysema, and other nonlung parenchymal findings. Results: MDR-TB group have 177 (96%) patients with large lesions, 6 (4%) with medium lesions, and no small lesions. DS-TB group have 55 (30%) patients with small lesions, 78 (43%) with medium lesions, and 50 (27%) ...
High resolution computed tomography and chest x-ray findings in patient with pulmonary tuberculosis
Journal of Chitwan Medical College, 2019
Background: Pulmonary Tuberculosis (PTB) is a major public health problem in Nepal. Diagnosis of pulmonary tuberculosis is done by bacteriological confirmation of respiratory specimen however Negative smear needs clinical and radiological evaluation for the diagnosis in suspected patient. This study focuses on radiological findings in both Pulmonary bacteriologically confirmed (PBC) and pulmonary clinically diagnosed (PCD) Tuberculosis. Methods: This observational study was conducted at Chitwan Medical College between Feb 2019 to July 2019. 45 Patient diagnosed with PTB were enrolled. Chest X-ray (CXR) and High Resolution Computed Tomography (HRCT) chest reports were analysed for the presence of findings that suggest active infection like cavity, consolidation, tree in bud, etc in PBC and PCD. Results: A total of 45 PTB patients with mean age: 54.60 ± 19 years were included. 53.3 % were PBC and 46.7 % were PCD tuberculosis, CXR findings in PBC and PCD tuberculosis was nodular inf...
Medicines
Chest X-ray (CXR) characteristics of patients with drug-resistant tuberculosis (DR-TB) depend on a variety of factors, and therefore, identifying the influence of these factors on the appearance of DR-TB in chest X-rays can help physicians improve diagnosis and clinical suspicion. Our aim was to describe the CXR presentation of patients with DR-TB and its association with clinical and demographic factors. A retrospective analysis of the CXRs of DR-TB patients in Nigeria between 2010 and 2016 was performed, reviewing features of chest radiographs, such as cavitation, opacity and effusion, infiltration and lung destruction. The association of these abnormal CXR findings with clinical and demographic characteristics was evaluated using bivariate and multivariate models, and a p-value < 0.05 was considered statistically significant with a 95% confidence interval. A total of 2555 DR-TB patients were studied, the majority (66.9%) were male, aged 29–38 years (36.8%), previously treated ...
Different Radiological Manifestations of pulmonary Tuberculosis
Pakistan Journal of Chest medicine, 2020
Background: Tuberculosis is a major public health problem affecting around 9 million people and causing 2 million deaths each year. A number of investigations are carried out to diagnose pulmonary tuberculosis; these include sputum smear for acid fast bacillus, Gene Xpert and the bronchoscopy. However, due to low sensitivity and/or cost effectiveness, chest X-rays are still commonly used for diagnostic purposes. This study was performed to know the different radiographic findings in diagnosed cases of Pulmonary Tuberculosis. Methodology: It was a cross sectional study performed on 144 diagnosed cases of pulmonary tuberculosis in the pulmonology unit of Ayub Teaching Hospital Abbottabad, from 1st September 2017 to 31st August 2018. Chest Xray was performed on all patients included in the study and their findings were recorded in a pro forma. Results: The study population comprised of 144 TB patients of either sex who had been newly diagnosed with TB. The youngest study participant wa...
Open Journal of Medical Imaging, 2014
We assessed the effect of an interpretation grid on the detection of CXR anomalies and radiographic diagnosis of tuberculosis in an endemic area for tuberculosis. Methods: The study was conducted in Yaounde (Cameroon). Six observers (2 pulmonologists, 2 radiologists and 2 senior residents in medical imaging) interpreted 47 frontal CXR twice two months apart without (R1) and with (R2) the aid of an interpretation grid. We focused on the detection of micro nodules (n = 16), cavitations (n = 12), pleural effusion (n = 6), adenomegaly (n = 6), and diagnosis of tuberculosis (n = 23) and cancer (n = 7). Results: The average score for accurate detection of elementary lesions was 40.4% [95%CI: 25% -58.3%] in R1 and 52.1% [36.9% -65.3%] in R2. The highest improvement was observed for micro nodules (19.8%). Cavitations had the highest proportions of accurate detections (58.3% in R1 and 65.3% in R2). The average score of accurate diagnosis was 46.1% in R1 and 57.4% in R2. Accurate diagnosis improved by 3.6% for tuberculosis and 19% for cancer between R1 and R2. Intra-observer agreement was higher for the diagnosis of cancers * Corresponding author.
International Journal of Research in Medical Sciences, 2014
Background: Aim of current study was to determine the clinical characteristics, radiological, laboratory features and anti-tubercular drug sensitivity in new smear positive (category I) pulmonary tuberculosis cases in a tertiary care dedicated TB OPD, Delhi. Methods: The study was a cross-sectional observational study and consists of 100 cases of new smear positive pulmonary tuberculosis cases (category I) irrespective of age and sex. The sputum were collected, stained with Ziehl-Nielsen (Z-N) staining and ultimately inoculated on Lowenstein-Jensen (L-J) media for six weeks. All sputum smear positive cases were subjected to culture and drug-susceptibility testing by 1% proportion method on Lowenstein-Jensen (LJ) medium. The Drug-Susceptibility Testing (DST) for isoniazid (INH), rifampicin (R-cin), ethambutol (EMB) and streptomycin (SM) were performed. Results: The age & sex distribution of 100 patients showed that majority of the patients (79%) belonged to 2 nd , 3 rd and 4 th decades & 60 % were males and 40% were female with male to female ratio 3:2 respectively. Cough (83%), fever (77%) and weight loss (76%) were the most common presenting clinical features. The chest X-ray of 100 smear positive patients showed that 53% of patients had evidence of 35% unilateral and 18% bilateral consolidation and 46% had cavitary lesions on chest X-ray (PA view) with 37% and 9% of patients having unilateral and bilateral cavities respectively. Of these 82 culture positives, 56.1% (n=46) were susceptible to all first-line anti-tubercular drugs, while 43.9% (n=36) were resistant to mostly one or other anti-tubercular drugs (INH, R-cin, SM or EMB). Conclusion: We stressed the importance of early diagnosis of new cases by clinico-pathological features, identifying of drug resistance trends in anti-tubercular treatment naïve patients, in order to assess the efficacy of current interventions. Overall, these findings emphasize the importance of early diagnosis of drug resistance pattern of M. tuberculosis isolates to anti-tubercular in category I patients as well as its association with HIV across the country to timely modify and strengthen the national programs in order to prevent the emergence of MDR-TB strains and avert the threat of XDR-TB.