The Radiological Spectrum of Pulmonary Multidrug-Resistant Tuberculosis in HIV-Negative Patients
Abstract:
Background
Multidrug-resistant tuberculosis (MDR-TB) is a major worldwide health problem. In countries where TB is of moderate to high prevalence, the issue of MDR-TB carries significant importance. MDR-TB, similar to drug-sensitive TB, is contagious. Meanwhile its treatment is not only more difficult but also more expensive with lower success rates. Regarding clinical findings, there is no significant difference between MDR-TB and drug-sensitive TB. Therefore determination of characteristic radiological findings in cases of MDR-TB might be of help in early detection, and hence appropriate management of this disease condition.
Objective
To explain the radiological spectrum of pulmonary MDR-TB. Patients and
Methods
We retrospectively evaluated the radiographic images of 35 patients with clinically- and microbiologically-proven MDR-TB admitted to our tertiary-care TB unit over a period of 13 months. The latest chest X-ray of all patients and the conventional chest CT scan without contrast of 15 patients were reviewed by three expert radiologists who rendered consensus opinion.
Results
Of the 35 patients with imaging studies, 23 (66%) were male and 12 (34%) were female. The mean±SD age of participants was 38.2±17.3 (range: 16–80) years. 33 patients were known as secondary and only 2 had primary MDR-TB. Chest radiography revealed cavitary lesion in 80%, pulmonary infiltration in 89% and nodules in 80% of the cases. Pleurisy was the rarest finding observed in only 5 (14%) patients. All of 15 chest CT scans revealed cavitation, 93% of which were bilateral and multiple. Pleural involvement was seen in 93% of patients.
Conclusion
Presence of multiple cavities, especially in both lungs, nodular and infiltrative lesions, and pleural effusion are main features of MDR-TB as compared to drug-sensitive TB.
Language:
English
Published:
Iranian Journal of Radiology, Volume:1 Issue: 3, Spring & Summer 2003
Page:
161
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