Radiological signs associated with pulmonary multi-drug resistant tuberculosis: an analysis of published evidences

Wáng, Yì Xiáng J.; Chung, Myung Jin; Skrahin, Aliaksandr; Rosenthal, Alex; Gabrielian, Andrei; Tartakovsky, Michael

doi:10.21037/qims.2018.03.06

Cited by 54 publications

(88 citation statements)

References 56 publications

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“…In a review published in early 2018, we summarized the radiological features for mdrptb (8). Till the end of 2017, the importance of multiple NCs as an imaging suggesting mdrptb was not recognized.…”

Section: Discussionmentioning

confidence: 99%

“…We are actively working to (1) increase the sample size of dsptb, (2) analyze and incorporate the mdrptb cases in Shenzhen Center for Chronic Disease Control into our mdrptb case pool, (3) incorporate other imaging features such as cavitary lesion and TB lesion lobular distribution etc into the prediction model. It has been suggested that multiple cavities, particularly those with thick wall, are associated with mdrptb or xdrptb (8, 15).…”

Section: Discussionmentioning

confidence: 99%

“…dsptb cases were from base the TBPP collection as well as the Shenzhen Center for Chronic Disease Control, Shenzhen, China (table-1). We excluded patients with HIV(+) status, as patients with compromised immunofunction have been noted to have different ptb presentation (8). The category of being dsptb, mdrptb, or xdrptb was based on either (1) sputum cultured M.tb drug sensitivity testing, or (2) M.tb molecular testing results, (3) clinically diagnosed, i. e. favorable response and outcome following standard treatment regimen for dsptb (table-2).…”

Section: Methodsmentioning

confidence: 99%

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Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

Huang

Skrahin

et al. 2019

Preprint

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Multidrug-resistant tuberculosis (mdrtb) refers to TB infection resistant to at least two most powerful anti-TB drugs, isoniazid and rifampincin. It has been estimated that globally 3.5% (which can be much higher in some regions) of newly diagnosed TB patients, and 20.5% of previously treated patients had mdrtb. Extensively drug-resistant TB (xdrtb) has resistance to rifampin and isoniazid, as well as to any member of the quinolone family and at least one of the second line injectable drugs: kanamycin, amikacin and capreomycin. xdrtb accounts for 4-20% of mdrtb. Early detection and targeted treatment are priorities for mdrtb/xdrtb control. The suspicion of mdr/xdr -pulmonary TB (mdrptb or xdrptb) by chest imaging shall suggest intensive diagnostic testing for mdrptb/xdrptb. We hypothesize that multiple nodular consolidation (NC) may serve one of the differentiators for separating dsptb vs mdrptb/xdrptb cases. For this study, mdrptb cases (n=310) and XDR-PTB cases (⋂=I58) were from the NIAID TB Portals Program (TBPP) <https://tbportals.niaid.nih.gov>. Drug sensitive pulmonary TB (dsptb) cases were from the TBPP collection (n=112) as well as the Shenzhen Center for Chronic Disease Control (n=111), Shenzhen, China, and we excluded patients with HIV(+) status. Our study shows NC, particularly multiple NCs, is more common in mdrptb than in dsptb, and more common in xdrptb than in mdrptb. For example, 2.24% of dsptb patients, 13.23% of mdrptb patients, and 20.89% of xdrptb patients, respectively, have NCs with diameter >= 10mm equal or more than 2 in number.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

Huang

Skrahin

et al. 2019

Preprint

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“…Other studies have reported rates of parenchymal abnormalities of 20–50%, some authors noting that invariably ipsilateral infiltrates which were not initially visible will become apparent on drainage of the effusion . Recently, data have suggested that pleural effusion may be more commonly found in drug‐resistant than in drug‐sensitive TB . Residual pleural thickening and lung encasement are possible long‐term sequelae visible on chest imaging (Fig.…”

Section: Chest Imagingmentioning

confidence: 99%

“…6,19 Recently, data have suggested that pleural effusion may be more commonly found in drug-resistant than in drug-sensitive TB. 40,41 Residual pleural thickening and lung encasement are possible long-term sequelae visible on chest imaging (Fig. 2).…”

Section: Chest Imagingmentioning

confidence: 99%

Tuberculous pleural effusion

2019

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Tuberculous effusion is a common disease entity with a spectrum of presentations from a largely benign effusion, which resolves completely, to a complicated effusion with loculations, pleural thickening and even frank empyema, all of which may have a lasting effect on lung function. The pathogenesis is a combination of true pleural infection and an effusive hypersensitivity reaction, compartmentalized within the pleural space. Diagnostic thoracentesis with thorough pleural fluid analysis including biomarkers such as adenosine deaminase and gamma interferon achieves high accuracy in the correct clinical context. Definitive diagnosis may require invasive procedures to demonstrate histological evidence of caseating granulomas or microbiological evidence of the organism on smear or culture. Drug resistance is an emerging problem that requires vigilance and extra effort to acquire a complete drug sensitivity profile for each tuberculous effusion treated. Nucleic acid amplification tests such as Xpert MTB/RIF can be invaluable in this instance; however, the yield is low in pleural fluid. Treatment consists of standard anti‐tuberculous therapy or a guideline‐based individualized regimen in the case of drug resistance. There is low‐quality evidence that suggests possible benefit from corticosteroids; however, they are not currently recommended due to concomitant increased risk of adverse effects. Small studies report some short‐ and long‐term benefit from interventions such as therapeutic thoracentesis, intrapleural fibrinolytics and surgery but many questions remain to be answered.

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The Role of Epigenetics in the Development of Anti-Tuberculosis Drug Resistance

2023

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Radiological signs associated with pulmonary multi-drug resistant tuberculosis: an analysis of published evidences

Abstract: Thick-walled multiple cavity lesions present the most promising radiological sign for MDR-TB diagnosis. For future studies cavity lesion characteristics should be quantified in details.

Cited by 54 publications

References 56 publications

Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

Prediction of multiple drug resistant pulmonary tuberculosis against drug sensitive pulmonary tuberculosis by CT nodular consolidation sign

Tuberculous pleural effusion

The Role of Epigenetics in the Development of Anti-Tuberculosis Drug Resistance

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