Radiographic manifestations of culture-positive pulmonary tuberculosis: cavitary or non-cavitary?
Abstract:OBJECTIVE: To examine the radiographic pattern of patients with pulmonary tuberculosis (PTB) in Saudi Arabia and the relation of these findings to demographic and microbiological data.
DESIGN: A retrospective hospital-based series of patients with culture-positive PTB.
RESULTS: Among 168 cases of culture-positive PTB identified, 97 (57.7%) were males and 71 females (42.3%); 136 (81%) were Saudis and 19% were non-Saudis. The mean age was 52.3 ± 19.2 years: nine (5.4%) were children aged ≤18 years and 64 (38.1%) were adults aged >60 years. Overall, 121 (78%) had upper lobe infiltrates, 35 (19.7%) had cavitary lesions and 33 (19.6%) had both upper lobe infiltrate and cavitation. Lymphadenopathy and pleural effusion were each present in 11.3% of the patients. Patients aged >60 years were less likely to have upper lobe infiltrate (38/64, 59.4%) compared to children (7/9, 77.8%) and adults aged 19–60 years (76/95, 80%, P = 0.001). Diabetes mellitus was documented in 57/135 (42.2%) patients. There was no difference in the presence of upper lobe infiltrate and the presence of cavitation in patients with and without diabetes mellitus.
CONCLUSION: Cavitary or upper lobe infiltrate remains a common presentation of PTB. As patients aged >60 years often present with no cavitation and without upper lobe infiltrate, it is important to keep in mind the possibility of tuberculosis in this group of patients.
Document Type: Regular Paper
Affiliations: Internal Medicine Services Division, Dhahran Health Centre, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran, Saudi Arabia
Publication date: 2009-03-01
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