Chest X-ray findings in drug-sensitive and drug-resistant pulmonary tuberculosis patients in Uganda

Oriekot, Anthony; Sereke, Senai Goitom; Bongomin, Felix; Bugeza, Samuel; Muyinda, Zeridah

doi:10.1016/j.jctube.2022.100312

Cited by 3 publications

(2 citation statements)

References 20 publications

(18 reference statements)

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“…There have been concerns that reported radiological feature differences between DS-PTB and MDR-PTB were confounded by that MDR cases tend to have a longer history prior to being diagnosed as MDR, thus the radiological features shown in MDR-PTB may not be intrinsic to MDR-PTB pathology. On the other hand, some studies did not show imaging feature difference between DS-PTB vs. MDR-PTB or did not show imaging feature difference between MDR-PTB vs. XDR-PTB (24,25).…”

Section: Discussionmentioning

confidence: 96%

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: a computerized tomography study with history length matched cases

Song¹,

Zheng²,

Wang³

et al. 2022

J Thorac Dis

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Background: There have been concerns that literature described radiological feature differences between drug-sensitive pulmonary tuberculosis (DS-PTB) and multidrug-resistant (MDR)-PTB were confounded by that MDR-PTB cases tend to have a longer history. Using history length matched DS-PTB and MDR-PTB cases from a well-defined urban region in Dalian, we retrospectively analysed the CT feature differences of these paired cases with a focus on pulmonary nodular (PN) consolidation and pulmonary cavity (PC).Methods: There were 33 consecutive MDR-PTB cases [inclusive of rifampicin-resistant (RR) cases, 27 males and 6 females, mean age: 49.2 years], with 19 cases had a history of <1 month and 8 and 6 cases had a history of 1-6 and >6 months respectively. To pair the MDR-PTB cases with history length, matched 33 cases of DS-PTB patients (21 males and 12 females, mean age: 56.5 years) were included. All patients were new PTB without HIV infection. The first CT exams prior to treatment were analysed.Results: Compared with DS cases, MDR cases had a much higher prevalence of PN (75.76% vs. 45.45%) and a higher number of PN per positive case for PN (6.2 vs.1.53). For the cases >1 month history, MDR-PTB had a higher number of PC per positive case than that of DS-PTB cases (7.18 vs. 2.36). To differentiate DS-PTB from MDR-PTB, receiver operating characteristic (ROC) analysis showed a cutoff PN number of ≥3 had 48.5% sensitivity and 93.9% specificity, and a cutoff PC number of ≥4 had 39.4% sensitivity and 84.9% specificity. The lung field distribution of all lesions tended to be wider for MDR-PTB cases. MDR-PTB cases appeared to be associated with a faster progression in the absence of treatment.Conclusions: MDR-TB is likely intrinsically more invasive than DS-TB. Multiple PN and Multiple PC are promising signs for the suspicion of MDR-PTB on chest imaging.

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Section: Discussionmentioning

confidence: 96%

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: a computerized tomography study with history length matched cases

Song¹,

Zheng²,

Wang³

et al. 2022

J Thorac Dis

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“…On the other hand, there may be no biological rationale that MDR-PTB shall demonstrates higher lung lesion extent or more lung destructions than DS-PTB. Some studies did not show imaging feature differences between DS-PTB vs. MDR-PTB or did not show imaging feature differences between MDR-PTB vs. XDR-PTB ( 25 - 27 ). In fact, that there is no imaging feature difference between DS-PTB and MDR-PTB is also the perception of many practicing radiologists (personal communications).…”

Section: Introductionmentioning

confidence: 99%

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: the Guangzhou computerized tomography study

Fang,

Tang,

Liang

et al. 2024

Quant Imaging Med Surg

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Background Pulmonary nodular consolidation (PN) and pulmonary cavity (PC) may represent the two most promising imaging signs in differentiating multidrug-resistant (MDR)-pulmonary tuberculosis (PTB) from drug-sensitive (DS)-PTB. However, there have been concerns that literature described radiological feature differences between DS-PTB and MDR-PTB were confounded by that MDR-PTB cases tend to have a longer history. This study seeks to further clarify this point. Methods All cases were from the Guangzhou Chest Hospital, Guangzhou, China. We retrieved data of consecutive new MDR cases [n=46, inclusive of rifampicin-resistant (RR) cases] treated during the period of July 2020 and December 2021, and according to the electronic case archiving system records, the main PTB-related symptoms/signs history was ≤3 months till the first computed tomography (CT) scan in Guangzhou Chest Hospital was taken. To pair the MDR-PTB cases with assumed equal disease history length, we additionally retrieved data of 46 cases of DS-PTB patients. Twenty-two of the DS patients and 30 of the MDR patients were from rural communities. The first CT in Guangzhou Chest Hospital was analysed in this study. When the CT was taken, most cases had anti-TB drug treatment for less than 2 weeks, and none had been treated for more than 3 weeks. Results Apparent CT signs associated with chronicity were noted in 10 cases in the DS group (10/46) and 9 cases in the MDR group (10/46). Thus, the overall disease history would have been longer than the assumed <3 months. Still, the history length difference between DS patients and MDR patients in the current study might not be substantial. The lung volume involvement was 11.3%±8.3% for DS cases and 8.4%±6.6% for MDR cases (P=0.022). There was no statistical difference between DS cases and MDR cases both in PN prevalence and in PC prevalence. For positive cases, MDR cases had more PN number (mean of positive cases: 2.63 vs. 2.28, P=0.38) and PC number (mean of positive cases: 2.14 vs. 1.38, P=0.001) than DS cases. Receiver operating characteristic curve analysis shows, PN ≥4 and PC ≥3 had a specificity of 86% (sensitivity 25%) and 93% (sensitivity 36%), respectively, in suggesting the patient being a MDR cases. Conclusions A combination of PN and PC features allows statistical separation of DS and MDR cases.

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Comparison of the Severity of Lung Damage on Chest X-ray Between New Drug-Resistant and Drug-Sensitive Cases of Pulmonary Tuberculosis Patients

Soedarsono,

Fauzi,

Widyoningroem

et al. 2023

Arch Clin Infect Dis

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Background: Drug-resistant (DR) pulmonary tuberculosis (TB) is often associated with morbidity and mortality compared to drug-susceptible (DS) pulmonary TB. The infectiveness and pathological destruction of DR TB and DS TB strains are still controversial. Objectives: This study aimed to compare the severity of lung damage between new cases of DR and DS pulmonary TB. Methods: This was an analytical observational study with a retrospective cross-sectional design. The sample was selected from the medical records of eligible TB patients treated at RSUD Dr. Soetomo, Surabaya (Indonesia) from January 2018 to November 2022. The severity of lung damage was assessed based on the chest X-ray. Results: A total of 319 patients, consisting of 132 new cases of DR pulmonary TB and 187 new cases of DS pulmonary TB, were recruited. The patients had a mean age of 43.64 years old, and 59.5% of them were male. The most common comorbidity was diabetes mellitus. The severity of DR pulmonary tuberculosis is higher in the mild-moderate category (51.5%), while the severity of DS pulmonary tuberculosis is higher in the severe category (77%). Conclusions: There was a difference in lung damage on chest X-ray between new cases of DR and DS pulmonary TB. The severity of DR pulmonary TB was higher in mild-moderate category, while the severity of DS pulmonary TB was higher in severe category.

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Chest X-ray findings in drug-sensitive and drug-resistant pulmonary tuberculosis patients in Uganda

Cited by 3 publications

References 20 publications

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: a computerized tomography study with history length matched cases

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: a computerized tomography study with history length matched cases

Differences in pulmonary nodular consolidation and pulmonary cavity among drug-sensitive, rifampicin-resistant and multi-drug resistant tuberculosis patients: the Guangzhou computerized tomography study

Comparison of the Severity of Lung Damage on Chest X-ray Between New Drug-Resistant and Drug-Sensitive Cases of Pulmonary Tuberculosis Patients

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