Impact of Pulmonary Tuberculosis Activity on Exhaled Breath Markers Levels in the Egyptian Population

Abstract

Introduction: Tuberculosis still characterizes till now a major respiratory insult with concurrent pulmonary manifestations and later disability. Aim of Work: To evaluate the level of exhaled fraction of nitric oxide (FENO) and fraction of exhaled carbon monoxide (FECO) as markers of pulmonary tuberculosis TB activity in patients under chemotherapy in comparison to healthy negative patients and latent TB patients. Patients and Methods: This cross-sectional study was conducted on 130 patients recruited from the outpatient clinic of Mansoura Chest hospital during the period from May 2019 to December 2019. They were categorized into the three groups: 1) Pulmonary tuberculous patients PTB (group1) which included 48 cases with positive sputum for TB bacilli in the initiation phase after 1 month of starting anti-tuberculous chemotherapy; 2) Latent patients (group 2): included 40 patients with positive tuberculin skin test (Mantoux test) > 10 mm. 3) Control patients (group 3) which included 42 healthy volunteers with negative sputum for TB bacilli. They were subjected to portable spirogram as well as exhaled fractional NO and CO measurement. Results: FECO and FENO levels prevailed in pulmonary TB patients followed by Latent TB patients and lastly healthy volunteers (42 ± 12.32/5 ± 0.16 & 38 ± 8.25/6 ± 2.25 and 23 ± 3.25/2 ± 0.40 respectively). Conclusion: Measurement of CO and NO level in expired air may correlate with active pulmonary TB infection in comparison to healthy negative tuberculous patients and latent tuberculous patients.