Pulmonary Tuberculosis: Up-to-Date Imaging and Management

Jeong, Yeon Joo; Lee, Kyung Soo

doi:10.2214/ajr.07.3896

Cited by 312 publications

(280 citation statements)

References 68 publications

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“…A common pathophysiology of TB and PSP is suggested by the fact that 5.4% of spontaneous pneumothorax patients had TB and 2.1% of patients with TB had PSP (22,23). This hypothesis also gives a potential explanation for the apical location of secondary TB in the lower lobe, whilst the conventional explanations of high apical oxygen levels and gravity for TB's apical localization appear to be invalid for the lower lobe (24).…”

mentioning

confidence: 99%

The link between tuberculosis and body mass index

Casha¹,

Scarci²

2017

J. Thorac. Dis.

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The evidence behind the strong correlation between reactivation of tuberculosis (TB) and low body mass index (BMI) was reviewed. This strong association between TB and BMI occurred only with pulmonary TB and not extra-pulmonary TB, indicating that a low-BMI body build may in some way predispose to TB reactivation in the lungs. A possible explanation may be the congenital apical lung bullae that occur in 15% of the population and are likely to enlarge in young low-BMI males since biomechanical modeling of pleural stress has shown a massive 40x increase in apical pleural stress in low antero-posterior (AP) diameter chests associated with a low-BMI build. This suggests that pre-existing lung cavities may predispose to TB reactivation instead of current thinking that cavitation occurs after reactivation. Supporting this hypothesis is the relatively common incidence of both TB and primary spontaneous pneumothorax (PSP) occurring simultaneously. Furthermore, this hypothesis also gives a potential explanation for the apical location of secondary TB in the lower lobe as the conventional explanations of high apical oxygen levels and gravity appear to be invalid for the lower lobe. This opens up the possibility of a clinical trial that low-dose computerized tomography (CT) may be used to screen for the presence of subclinical apical bullae in low-BMI, high TB risk cohorts.

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mentioning

confidence: 99%

The link between tuberculosis and body mass index

Casha¹,

Scarci²

2017

J. Thorac. Dis.

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“…Chest X-ray found lymphadenopathies predominantly in hilar region. Indeed, there was no significant difference for hilar lymphadenopathy detection between CT and chest X-ray, while thoracic CT scan recognized lymph node enlargement in mediastinal region much more effectively, this is due to mediastinal lymph node superimposition over the sternum and bony spine on chest X-ray; however, none of these regions are considered more specific for tuberculosis infection [21]. As expected, collapse, especially subsegmental type and band atelectasis and pleural effusion/ thickening were the other findings depicted significantly better by thoracic CT in comparison with chest X-ray.…”

Section: Discussionmentioning

confidence: 88%

Comparison of Digital Chest X-Ray and Thoracic Computed Tomography Scan in Childhood Tuberculosis

Bolursaz

Mehrian

Agha‐Hosseini

et al. 2015

Zahedan J Res Med Sci

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Background:Imaging is the mainstay of diagnostic criteria in tuberculosis (TB) diagnosis, especially in children; however, the exact role of chest X-ray (CXR) and thoracic CT scan (TCT) still remains controversial. The aim of this study is to compare digital chest X-ray and thoracic CT scan in childhood tuberculosis. Materials and Methods: In this retrospective comparative study, 38 children under 15 years old with proved diagnosis of TB who were admitted to Massih Daneshvari hospital during 2010 to 2012. Digital chest X-ray and spiral thoracic CT was performed before starting medication. Results: Direct smear for acid-fast bacillus was positive only in 38%. Positive tuberculin skin test was seen in 51% of the cases. Chest X-ray was normal in 36.8% of children, while CT scan was negative only in 21%. Overall sensitivity of thoracic CT scan and chest X-ray were 78.9% and 63.2%, respectively which show no significant difference. CT scan detected lymphadenopathy, nodule/nodular infiltration, collapse and pleural effusion/ thickening significantly better than chest X-ray; however, there was no significant difference between CXR and TCT in detection rate of consolidation/ground glass opacity, bronchiectasis, cicatricial volume loss and cavity/abscess. Conclusions: This study proposed that investigation of children suspicious of tuberculosis by digital chest X-ray is still of great value. It seems that thoracic CT scan in children suspected of tuberculosis infection can be limited only to investigation of complications in selected patients.

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“…Regarding the signs and symptoms presented with, while 16% of people were asymptomatic, fever, cough, simultaneous fever and cough and dyspnea were the most common symptoms. In fact studies from elsewhere have reported differently about the prevalence of signs and symptoms (1,16,(19)(20)(21). History of being exposed to an adult with positive smear pulmonary tuberculosis is the most important factor in contracting the disease and diagnosis in children.…”

Section: Discussionmentioning

confidence: 99%

Childhood Tuberculosis in Kermanshah, Iran, During 10 Years

Ghadiri

Najafi

Solimani

et al. 2013

Arch Pediatr Infect Dis

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Background: Tuberculosis in children still remains as one of the main causes of morbidity and mortality throughout the world. Objectives: The aim of this study was to evaluate the epidemiological aspects of childhood tuberculosis in Kermanshah, Iran. Patients and Methods: Medical records of all 150 patients aged 0-18 in Kermanshah district who were diagnosed according to WHO criteria for 10 years were retrospectively reviewed. As well as presenting demographic and clinical aspects of patients, we calculated notification rate. Results: 35% of cases were male and 65% were female. Of total 150 tuberculosis cases, 56% were pulmonary and 44% were extra pulmonary. The most common symptoms were fever and cough. About 16% were asymptomatic. About 17% of patients had adult pulmonary tuberculosis in their families. The mean of the number of people living in a family (5.5) was similar in both pulmonary and extra pulmonary types. Except for year 2002, for all years the notification rate in girls was higher than that in boys. Over 10 years of study, the notification rate was 3.75/100,000 with no significant trend. Conclusions: Based on our results, rate of diagnosis seemed under the expected range, in particular in children under 5. Therefore, we recommend that authorities come up with programs that aim at raising awareness about the importance of diagnosis of pediatric tuberculosis.

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Pulmonary Tuberculosis: Up-to-Date Imaging and Management

Cited by 312 publications

References 68 publications

The link between tuberculosis and body mass index

The link between tuberculosis and body mass index

Comparison of Digital Chest X-Ray and Thoracic Computed Tomography Scan in Childhood Tuberculosis

Childhood Tuberculosis in Kermanshah, Iran, During 10 Years

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