The Diagnostic Deceiver: Radiological Pictorial Review of Tuberculosis

Abstract

Tuberculosis (TB) is a bacterial infection with Mycobacterium tuberculosis; it is a public health problem worldwide and one of the leading causes of mortality. Since December 2019, the COVID-19 pandemic has created unprecedented health challenges and disrupted the TB health services, especially in high-burden countries with ever-increasing prevalence. Extrapulmonary and even pulmonary TB are an important cause of nonspecific clinical and radiological manifestations and can masquerade as any benign or malignant medical case, thus causing disastrous conditions and diagnostic dilemmas. Clinical manifestations and routine laboratory tests have limitations in directing physicians to diagnose TB. Medical-imaging examinations play an essential role in detecting tissue abnormalities and early suspecting diagnosis of TB in different organs. Radiologists and physicians should be familiar with and aware of the radiological manifestations of TB to contribute to the early suspicion and diagnosis of TB. The purpose of this article is to illustrate the common radiologic patterns of pulmonary and extrapulmonary TB. This article will be beneficial for radiologists, medical students, chest physicians, and infectious-disease doctors who are interested in the diagnosis of TB.

Minimally Invasive Surgical Approach to Decompress a Multi-Loculated Abscess in the Thoracic Spine: A Case Report

“…It involves bacteriological or microscopic examination, culture test of the infected tissues taking into consideration fi ndings from imaging tests, blood cultures, and histopathological analysis. MRI is also valuable for diagnosing Potts disease because it can show spinal deformities, disc destruction, or abscesses [5]. The disease can remain undiagnosed or be diagnosed later due to the lack of specifi c clinical manifestations involving severe neurologic complications for the patient [6], who may progress to incomplete or complete paraplegia [7].…”

Management of liver hydatid cyst: A case report

“…However, ultrasonography is less sensitive in detecting small cysts and compression effects due to enlarged liver 1 . A computed tomography (CT) scan of the abdomen and pelvis should be used for definitive diagnosis 2,3,5 . CT scan is more sensitive to detect calcification, small cysts, internal septa, daughter vesicles, and hepatomegaly's compression effects 6 .…”

“…Daughter cysts appear hypoattenuating with a honeycomb appearance and multiple internal septations representing walls of daughter cysts, reflecting Type II hydatid disease 6 . A total calcification reflects the dead cysts and is hyperattenuating on a CT scan 5,6 . We did an urgent computed tomography scan of the abdomen and pelvis (Figure 1).…”

“…1 A computed tomography (CT) scan of the abdomen and pelvis should be used for definitive diagnosis. 2,3,5 CT scan is more sensitive to detect calcification, small cysts, internal septa, daughter vesicles, and hepatomegaly's compression effects. 6 Daughter cysts appear hypoattenuating with a honeycomb appearance and multiple internal septations representing walls of daughter cysts, reflecting Type II hydatid disease.…”

EBUS-GS with the GeneXpert MTB/RIF assay for diagnosis of Mycobacterium tuberculosis infection of isolated pulmonary nodules

“…Pulmonary tuberculoma is a special type of secondary pulmonary TB that has no characteristic clinical manifestations, but has imaging manifestations of atypical non-calci ed solitary pulmonary nodules. Pulmonary tuberculoma can be easily confused with peripheral lung cancer, pulmonary sarcoidosis, benign lung tumor, and other conditions [5][6][7]. Patients with pulmonary tuberculoma have extremely low rates of smear-positive and culturepositive sputum.…”