Clinical Investigation of Cavitary Tuberculosis and Tuberculous Pneumonia

Abstract

BackgroundThe radiographic characteristics of tuberculous pneumonia in adults are similar to primary tuberculosis that occurs in childhood, and upper lobe cavitary tuberculosis is the hallmark of postprimary tuberculosis. The purpose of this study was to investigate the factors associated with tuberculous pneumonia by making comparison with cavitary tuberculosis.MethodsThe medical records and radiographic findings of patients with cavitary tuberculosis and tuberculous pneumonia, and who were diagnosed between March 2003 and February 2006, were analyzed retrospectively.ResultsForty patients had cavitary tuberculosis and sixteen patients had tuberculous pneumonia. Fever was more frequent for tuberculous pneumonia, whereas hemoptysis was more frequent for cavitary tuberculosis. The duration of symptoms before visiting the hospital was shorter, but the diagnosis after admission was more delayed for tuberculous pneumonia patients than for cavitary tuberculosis patients. The prevalence of underlying comorbidities such cancer, diabetes, alcoholism and long-term steroid use was not different between the two groups. The patients with tuberculous pneumonia were older and they had lower levels of serum albumin and hemoglobin than those with cavitary tuberculosis. The patients with tuberculous pneumonia showed a tendency to have more frequent endobronchial lesion. Tuberculous pneumonia occurred in any lobe, whereas the majority of cavitary tuberculosis patients had upper lung lesion, but the prevalence of lymphadenopathy, pleural effusion and previous tuberculosis scar was not different between the two groups.ConclusionsOlder age, a lower level of serum albumin and hemoglobin and a random distribution of lesion were associated with tuberculosis pneumonia as compared with cavitary tuberculosis. These findings suggest that the pathogenesis of tuberculous pneumonia might be different from that of cavitary tuberculosis.

Pathology of post primary tuberculosis of the lung: An illustrated critical review

“…It is well known that very young, aged or immunosuppressed people are more likely to die of disseminated tuberculosis, but are less likely to develop cavities 58, 59 .…”

Mycobacterial Clearance from Sputum Is Delayed during the First Phase of Treatment in Patients with Diabetes

“…1–7 There is evidence that TB patients with DM may have higher bacillary loads than patients with TB without DM, but others have not confirmed these observations. 8–12 The impact of DM on reduction in bacillary load during TB treatment and the potential for transmission is also unclear. In the light of this uncertainty we sought to determine whether TB patients with DM patients were more likely to take longer to clear the bacterium from sputum during the first phase of treatment than those with TB patients without DM.…”

PredictingMycobacterium tuberculosisin patients with community-acquired pneumonia

“…For instance, in a cohort of 2228 patients with TB in Brazil, 59 (2%) patients presented with noncavitary pulmonary consolidation, which occurred predominantly in the upper lobes [22]. In another study of 16 patients with tuberculous pneumonia, consolidations occurred more evenly in the lung lobes, and these patients had more fever, less haemoptysis and shorter duration of disease as compared with patients with cavitary TB [23]. In TB patients from our study, only one had a cavitary lesion, and most lesions were located in the upper lobe.…”