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Free Content Pulmonary TB and NTM lung disease: comparison of characteristics in patients with AFB smear-positive sputum

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Abstract:

OBJECTIVE: To compare the clinical and radiographic features of pulmonary tuberculosis (PTB) and non-tuberculous mycobacteria (NTM) lung disease in patients with acid-fast bacilli (AFB) positive sputum specimens.

DESIGN: The initial clinical and radiographic features of 229 PTB patients were compared with those of 70 patients with NTM lung disease. The most commonly involved organisms in the NTM lung disease cases were Mycobacterium avium complex (n = 38, 54%) and M. abscessus (n = 26, 37%).

RESULTS: Clinical and radiographic findings that were more common in patients with NTM lung disease than in PTB patients were: older age (P < 0.001), non-smoker (P < 0.001), history of previous TB treatment (P < 0.001), absence of pleural effusion (P = 0.017), involvement of middle and/or lower lung zones (P = 0.007), and bilateral disease (P = 0.005). Multivariate analysis showed that older age (≥40 years), non-smoker, previous TB treatment, absence of pleural effusion and involvement of middle and/or lower lung zones were significant independent predictors for NTM lung disease.

CONCLUSIONS: There is considerable overlap in the clinical and radiographic appearances of PTB and NTM lung disease. The isolation and identification of causative organisms are mandatory for a correct diagnosis in patients with AFB-positive sputum specimens.

Keywords: Mycobacterium avium complex; atypical mycobacteria; differential diagnosis; lung diseases; pulmonary tuberculosis

Document Type: Regular Paper

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 2: Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 3: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

Publication date: September 1, 2006

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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