Negative sputum smear results in HIV-positive patients with pulmonary tuberculosis in Lusaka, Zambia

Introduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients.

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Utility Of Bronchoalveolar Lavage In Diagnosis Of Sputum/smear-Negative Pulmonary Tuberculosis In A Non-Endemic Area With A High Proportion Of HIV Positive Patients

10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a1204 ◽

2011 ◽

Author(s):

Dilys Lai ◽

Louis Koizia ◽

Nishma Manek ◽

Emma H. Baker

Keyword(s):

Pulmonary Tuberculosis ◽

Bronchoalveolar Lavage ◽

Endemic Area ◽

Hiv Positive ◽

Sputum Smear ◽

Smear Negative

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Comparison of Xpert MTB/RIF Assay and the Conventional Sputum Microscopy in DetectingMycobacterium tuberculosisin Northern Thailand

Tuberculosis Research and Treatment ◽

10.1155/2015/571782 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 7

Author(s):

Kanokwan Pinyopornpanish ◽

Romanee Chaiwarith ◽

Chansom Pantip ◽

Rassamee Keawvichit ◽

Kanlaya Wongworapat ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Cross Sectional Study ◽

University Hospital ◽

Sputum Smear ◽

Cross Sectional ◽

Sputum Microscopy ◽

Lower Specificity ◽

Negative Sputum ◽

Low Sensitivity ◽

Higher Sensitivity

Background.Despite low sensitivity in detection ofMycobacterium tuberculosis, sputum acid-fast smear remains the main diagnostic method. This study aimed to compare the diagnostic performance of Xpert MTB/RIF assay versus conventional sputum acid-fast smear.Materials and Methods.A cross-sectional study was conducted at Chiang Mai University Hospital, Thailand. Patients who were ≥15 years old and had clinically suspected pulmonary tuberculosis were included.Results.109 specimens from 57 patients were included. Using MGIT sputum culture as a reference standard, the sensitivity (SEN) and specificity (SPEC) for Xpert were 95.3% (95% CI, 84.2%, 99.4%) and 86.4% (95% CI, 75.7%, 93.6%). The SEN and SPEC for sputum acid-fast smear were 60.5% (95% CI, 44.4%, 75.0%) and 98.5% (95% CI, 91.8%, 100%). Xpert had significantly higher sensitivity (pvalue < 0.001) and lower specificity (pvalue = 0.022) than sputum acid-fast smear. Among 43 culture-provenM. tuberculosisspecimens, sensitivity of Xpert was 100% (95% CI, 86.7%, 100%) in acid-fast positive smears (n=26) and 88.2% (95% CI, 63.5%, 98.5%) in acid-fast negative smears (n=17).Conclusions.The good sensitivity and specificity of Xpert assay in detectingM. tuberculosisfrom sputum specimens may help in early diagnosis and treatment of pulmonary tuberculosis, particularly among patients who had acid-fast negative sputum smear.

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Pulmonary Tuberculosis in HIV-infected Patients Presenting with Normal Chest Radiograph and Negative Sputum Smear

J of Health Science ◽

10.17265/2328-7136/2016.03.003 ◽

2016 ◽

Vol 4 (3) ◽

Author(s):

Mounika Arrabelli ◽

Raghuram Reddy Adidala ◽

Chakrapani Chatla ◽

Shireesha T ◽

Suryaprakash Chakramahanty ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Chest Radiograph ◽

Sputum Smear ◽

Normal Chest Radiograph ◽

Normal Chest ◽

Negative Sputum

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Extensive transmission of Mycobacterium tuberculosis from 9 year old child with pulmonary tuberculosis and negative sputum smear

BMJ ◽

10.1136/bmj.a1184 ◽

2008 ◽

Vol 337 (aug28 1) ◽

pp. a1184-a1184 ◽

Cited By ~ 14

Author(s):

S Paranjothy ◽

M Eisenhut ◽

M Lilley ◽

S Bracebridge ◽

I Abubakar ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Sputum Smear ◽

Negative Sputum

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Characteristics of pulmonary tuberculosis in HIV seropositive and seronegative patients in a Northeastern region of Brazil

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822004000100012 ◽

2004 ◽

Vol 37 (1) ◽

pp. 46-50 ◽

Cited By ~ 29

Author(s):

Isabella Ramos de Oliveira Liberato ◽

Maria de Fatima P. Militão de Albuquerque ◽

Antônio Roberto Leite Campelo ◽

Heloísa Ramos Lacerda de Melo

Keyword(s):

Pulmonary Tuberculosis ◽

Clinical Laboratory ◽

Sputum Smear ◽

Tuberculosis Patients ◽

Hiv Coinfection ◽

Hiv Virus ◽

Immunodeficiency Virus ◽

Negative Sputum ◽

Reaction Result ◽

Sputum Smear Examination

The aim of this study was to analyse the clinical, epidemiological and bacteriological features present in 60 pulmonary tuberculosis patients who were also infected with human immunodeficiency virus (HIV) and to compare these with 120 TB patients who were not infected with HIV. The patients with pulmonary tuberculosis and HIV coinfection were mostly male (p = 0.001), showed a higher frequency of weight loss >10 kilos (p <0.001), had a higher rate of non-reaction result to the tuberculin skin test (p <0.001), a higher frequency of negative sputum smear examination for acid-fast bacilli (p = 0.001) and negative sputum culture for Mycobacterium tuberculosis (p = 0.001). Treatment failure was more common in those who were HIV positive (p <0.000). No higher frequency of resistance to antituberculosis drugs was found to be associated with TB/HIV coinfection (p = 0.407). Association between extrapulmonary and pulmonary tuberculosis was more frequent in those seropositive to HIV than those without HIV virus, 30% and 1.6% respectively. These findings showed a predominance of atypical clinical laboratory features in co-infected patients, and suggest that health care personnel should consider the possibility this diagnosis.

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Enhancement of Diagnostic Efficiency by a Gamma Interferon Release Assay for Pulmonary Tuberculosis

Clinical and Vaccine Immunology ◽

10.1128/cvi.00026-08 ◽

2008 ◽

Vol 15 (6) ◽

pp. 1028-1030 ◽

Cited By ~ 15

Author(s):

Kelly Aparecida Kanunfre ◽

Olavo Henrique Munhoz Leite ◽

Max Igor Lopes ◽

Marcelo Litvoc ◽

Antonio Walter Ferreira

Keyword(s):

Pulmonary Tuberculosis ◽

Operating Characteristic ◽

Characteristic Curve ◽

Sputum Smear ◽

Smear Microscopy ◽

Diagnostic Efficiency ◽

Active Pulmonary Tuberculosis ◽

Negative Culture ◽

Release Assay ◽

Negative Sputum

ABSTRACT This study was designed to examine the use of the QuantiFERON-TB Gold assay as an aid in the diagnosis of active pulmonary tuberculosis (TB) in Brazilian patients. Using the receiver operating characteristic curve, the cutoff was adjusted to ≥0.20 IU/ml. The sensitivity increased to 86%, with 100% specificity. All TB patients with negative sputum smear microscopy and negative culture results were positive using this test.

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Study of Clinical, Laboratory and Radiological Spectrum of Tuberculosis in HIV-Infected Individuals and Its Correlation with CD4 Count

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/198 ◽

2021 ◽

Vol 8 (16) ◽

pp. 1025-1029

Author(s):

Lavanya Devi Palaniswamy ◽

Moogaambiga Solai Raja Pandiyan ◽

Punitha Murugesan

Keyword(s):

Pulmonary Tuberculosis ◽

Tuberculin Test ◽

Cd4 Count ◽

Hiv Positive ◽

Sputum Smear ◽

Cd4 Counts ◽

X Ray ◽

Keywords Hiv ◽

Chest X Ray ◽

Extra Pulmonary

BACKGROUND Tuberculosis is often more difficult to diagnose and more complicated to treat among people who are human immunodeficiency virus (HIV) positive. This study was conducted to assess the clinical, microbiological, laboratory and radiological spectrum of tuberculosis (TB) in HIV seropositive patients, and explore its possible correlation with their CD4 count. METHODS A total of 104 patients who were western blot positive for HIV and co-infected with tuberculosis were studied in Salem district of Tamil Nadu. A detailed history was obtained and patients were examined clinically. CD4 count, sputum smear for acid fast bacilli (AFB), chest x-ray, and tuberculin test, were done along with other relevant investigations. The relationship between CD4 count, and the type of tuberculosis, sputum smear, chest x-ray, and tuberculin test, were analysed statistically, and P < 0.05 was considered significant. RESULTS Most of the patients were between 30 to 39 years. Males (84.6 %) outnumbered females (15.4 %). Pulmonary tuberculosis alone was seen in 47 patients, while extra pulmonary tuberculosis in 36 cases, and both pulmonary and extra pulmonary occurred in 21 cases. They had a mean CD4 count of 237.7 cells / μL, 135.2 cells / μL and 120.9 cells / μL respectively. Extrapulmonary tuberculosis and combined forms were associated with lower CD4 counts (P-value 0.005). The mean CD4 count of sputum positive, sputum negative, and multiple drug resistant (MDR) tuberculosis were 294.2, 168.3 and 90.2 cells / μL respectively. Lower CD4 count was associated with sputum - ve TB (P < 0.041). Lower CD4 counts were associated with atypical chest X-ray findings (P < 0.006) and negative tuberculin test (P < 0.001). CONCLUSIONS Sputum smear positivity for AFB decreases as CD4 count reduces. Involvement of lungs tend to be atypical in immunocompromised patients. The diagnosis of TB in HIV positive individuals is complex and a high index of suspicion is needed. KEYWORDS HIV, Tuberculosis, CD4 Cell Count, Sputum Smear for AFB, Chest X-Ray

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