Comparison of chest computed tomography features between pulmonary tuberculosis patients with culture-positive and culture-negative sputum for non-mycobacteria

Abstract Aim This study mainly evaluates the clinical characteristics and chest chest computed tomography (CT) findings of AFB-positive and AFB-negative pulmonary tuberculosis (PTB) patients to explore the relationship between AFB-positive and clinico-radiological findings. Methods A retrospective analysis of 224 hospitalized tuberculosis patients from 2018 to 2020 was undertaken. According to the AFB smear results, they were divided into AFB-positive pulmonary tuberculosis (positive by Ziehl–Neelsen staining) and AFB-negative pulmonary tuberculosis and patients’ CT results and laboratory test results were analyzed. Results A total of 224 PTB patients were enrolled. AFB-positive (n = 94, 42%) and AFB-negative (n = 130, 58%). AFB-positive patients had more consolidation (77.7% vs. 53.8%, p < 0.01), cavity (55.3% vs. 34.6%, p < 0.01), calcification (38.3% vs. 20%, p < 0.01), bronchiectasis (7.5% vs. 1.5%, p < 0.05), bronchiarctia (6.4% vs. 0.8%, p < 0.05), and right upper lobe involvement (57.5% vs. 33.1%, p < 0.01), left upper lobe involvement (46.8% vs. 33.1%, p < 0.05) and lymphadenopathy (58.5% vs. 37.7%, p < 0.01). Conclusion The study found that when pulmonary tuberculosis patients have consolidation, cavity, upper lobe involvement and lymphadenopathy on chest CT images, they may have a higher risk of AFB-positive tuberculosis.

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Detection of Mycobacterium tuberculosis in smear negative sputum by PCR

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v6i2.19368 ◽

2012 ◽

Vol 6 (2) ◽

pp. 2-6 ◽

Cited By ~ 1

Author(s):

Mohammad Jobayer ◽

SM Shamsuzzaman ◽

Kazi Zulfiquer Mamun

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Accurate Method ◽

Major Health Problem ◽

Major Health ◽

Tuberculosis Patients ◽

Diagnostic Potential ◽

Total Death ◽

Smear Negative ◽

Negative Sputum

Pulmonary tuberculosis is a major health problem in Bangladesh that is responsible for about 7% of total death in a year. This study was conducted to isolate and identify Mycobacterium tuberculosis from sputum and to evaluate the efficacy of PCR as a modern diagnostic tool, for diagnosis of pulmonary tuberculosis, especially in the smear negative cases. One hundred and fifty suspected pulmonary TB patients (male/ female: 97/53) were included in this study. Single morning sputum was collected from each patient and diagnostic potential of PCR was compared with staining and culture. Twenty five (16.7%) sputum were positive by ZN stained smear. Among 125 smear negative samples, 13 (10.4%) yielded growth in culture in LJ media and 21 (16.8%) samples were positive by PCR. The sensitivity and specificity of PCR in smear negative cases was 100% and 92.9% respectively. Mean detection time in PCR was 24 hours. PCR detected M. tuberculosis in 21 smear negative and 9 culture negative samples. For diagnosis of tuberculosis in smear negative cases, PCR directly from sputum was a very sensitive and accurate method. In conclusion, PCR may be done, especially in clinically suspected pulmonary tuberculosis patients who remain negative by conventional methods.DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19368 Bangladesh J Med Microbiol 2012; 06(02): 2-6

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Evaluation of the performance of clinical predictors in estimating the probability of pulmonary tuberculosis among smear-negative cases in Northern Ethiopia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-037913 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037913

Author(s):

Mala George ◽

Geert-Jan Dinant ◽

Efrem Kentiba ◽

Teklu Teshome ◽

Abinet Teshome ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Cross Sectional Study ◽

Clinical Suspicion ◽

Secondary Outcome ◽

Northern Ethiopia ◽

Sectional Study ◽

Cross Sectional ◽

Smear Negative ◽

Culture Positive ◽

Culture Negative

ObjectivesTo evaluate the performance of the predictors in estimating the probability of pulmonary tuberculosis (PTB) when all versus only significant variables are combined into a decision model (1) among all clinical suspects and (2) among smear-negative cases based on the results of culture tests.DesignA cross-sectional study.SettingTwo public referral hospitals in Tigray, Ethiopia.ParticipantsA total of 426 consecutive adult patients admitted to the hospitals with clinical suspicion of PTB were screened by sputum smear microscopy and chest radiograph (chest X-ray (CXR)) in accordance with the Ethiopian guidelines of the National Tuberculosis and Leprosy Program. Discontinuation of antituberculosis therapy in the past 3 months, unproductive cough, HIV positivity and unwillingness to give written informed consent were the basis of exclusion from the study.Primary and secondary outcome measuresA total of 354 patients were included in the final analysis, while 72 patients were excluded because culture tests were not done.ResultsThe strongest predictive variables of culture-positive PTB among patients with clinical suspicion were a positive smear test (OR 172; 95% CI 23.23 to 1273.54) and having CXR lesions compatible with PTB (OR 10.401; 95% CI 5.862 to 18.454). The regression model had a good predictive performance for identifying culture-positive PTB among patients with clinical suspicion (area under the curve (AUC) 0.84), but it was rather poor in patients with a negative smear result (AUC 0.64). Combining all the predictors in the model compared with only the independent significant variables did not really improve its performance to identify culture-positive (AUC 0.84–0.87) and culture-negative (AUC 0.64–0.69) PTB.ConclusionsOur finding suggests that predictive models based on clinical variables will not be useful to discriminate patients with culture-negative PTB from patients with culture-positive PTB among patients with smear-negative cases.

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Sustained elevated levels of C-reactive protein and ferritin in pulmonary tuberculosis patients remaining culture positive upon treatment initiation

PLoS ONE ◽

10.1371/journal.pone.0175278 ◽

2017 ◽

Vol 12 (4) ◽

pp. e0175278 ◽

Cited By ~ 11

Author(s):

Pryscila Miranda ◽

Leonardo Gil-Santana ◽

Marina G. Oliveira ◽

Eliene D. D. Mesquita ◽

Elisangela Silva ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Treatment Initiation ◽

C Reactive Protein ◽

Tuberculosis Patients ◽

Reactive Protein ◽

Culture Positive

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792. Number and Volume of Cavitary Lesions on Chest Computed Tomography Associated With Prolonged Time to Culture Conversion in Drug-Susceptible Pulmonary Tuberculosis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.799 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S284-S284

Author(s):

Alfonso Hernandez

Keyword(s):

Computed Tomography ◽

Pulmonary Tuberculosis ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Chest Roentgenogram ◽

Sputum Smear ◽

Chest Computed Tomography ◽

Median Difference ◽

Cox Proportional Hazards Models ◽

Culture Conversion

Abstract Background Cavitary lesions (CLs) may be a marker of poor treatment response in pulmonary tuberculosis (PTB). Identification of CLs by chest roentgenogram (CXR) has important limitations. Chest computed tomography (CT) is more sensitive than CXR to detect CLs but the clinical relevance of CLs identified by CT remains understudied. We compared detection of CLs between CT and CXR and assessed their association with time to sputum culture conversion (tSCC). We hypothesized that increasing number and volume of CLs on CT would be associated with prolonged tSCC. Methods Retrospective cohort study of 141 culture confirmed PTB patients who underwent chest CT. We used multivariate Cox proportional hazards models to evaluate the association between chest radiological features and tSCC. Results Seventy-five (53%) patients had one or more CLs on CT. CT identified cavities in 31% of patients without a CL on CXR. Detection of cavity on CT was associated with an increased median [IQR] time to culture conversion (15 [7–35] days among noncavitary CT vs. 39 [25–55] days among cavitary CT; P < 0.0001). Among patients without CL on CXR, detection of CL on CT was associated with prolonged tSCC (median difference (CI): 16 (7–25) days, P = 0.0008). Similar results were observed among patients with 3–4+ sputum smear (median difference: 19.5 (8–31) days, P = 0.001). Adjusted Kaplan–Meier curves of number and volume of CLs and tSCC are shown in Figure 1. After confounder adjustment patients with single and multiple CL had a prolonged tSCC relative to patients without CLs on CT (adjusted Hazard Ratio [aHR] 0.56 (0.32–0.97) and 0.31 (0.16–0.60), respectively). Similarly, patients with CL volume 25 mL or more had a prolonged tSCC (aHR 0.39 (0.21–0.72)). CXR CL was not associated with prolonged tSCC. Conclusion We observed a dose–response relationship between increasing number and volume of CLs on CT and delayed tSCC independent of sputum bacillary load. Our findings highlight a role for CT in a clinical research setting to predict shorter time to culture conversion. Disclosures All authors: No reported disclosures.

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Analysis of the Clinical Characteristics of Tuberculosis Patients based on Multi-Constrained Computed Tomography (CT) Image Segmentation Algorithm

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.6-wit.4795 ◽

2021 ◽

Vol 37 (6-WIT) ◽

Author(s):

Feng Zhu ◽

Bo Zhang

Keyword(s):

Computed Tomography ◽

Lung Cancer ◽

Image Segmentation ◽

Pulmonary Tuberculosis ◽

Clinical Characteristics ◽

Ct Image ◽

Segmentation Method ◽

Tuberculosis Patients ◽

Cancer Group ◽

Image Segmentation Algorithm

Objective: We used U-shaped convolutional neural network (U_Net) multi-constraint image segmentation method to compare the diagnosis and imaging characteristics of tuberculosis and tuberculosis with lung cancer patients with Computed Tomography (CT). Methods: We selected 160 patients with tuberculosis from the severity scoring (SVR) task is provided by Image CLEF Tuberculosis 2019. According to the type of diagnosed disease, they were divided into tuberculosis combined with lung cancer group and others group, all patients were given chest CT scan, and the clinical manifestations, CT characteristics, and initial suspected diagnosis and missed diagnosis of different tumor diameters were observed and compared between the two groups. Results: There were more patients with hemoptysis and hoarseness in pulmonary tuberculosis combined with lung cancer group than in the pulmonary others group (P<0.05), and the other symptoms were not significantly different (P>0.05). Tuberculosis combined with lung cancer group had fewer signs of calcification, streak shadow, speckle shadow, and cavitation than others group; however, tuberculosis combined with lung cancer group had more patients with mass shadow, lobular sign, spines sign, burr sign and vacuole sign than others group. Conclusion: The symptoms of hemoptysis and hoarseness in pulmonary tuberculosis patients need to consider whether the disease has progressed and the possibility of lung cancer lesions. CT imaging of pulmonary tuberculosis patients with lung cancer usually shows mass shadows, lobular signs, spines signs, burr signs, and vacuoles signs. It can be used as the basis for its diagnosis. Simultaneously, the U-Net-based segmentation method can effectively segment the lung parenchymal region, and the algorithm is better than traditional algorithms. doi: https://doi.org/10.12669/pjms.37.6-WIT.4795 How to cite this:Zhu F, Zhang B. Analysis of the Clinical Characteristics of Tuberculosis Patients based on Multi-Constrained Computed Tomography (CT) Image Segmentation Algorithm. Pak J Med Sci. 2021;37(6):1705-1709. doi: https://doi.org/10.12669/pjms.37.6-WIT.4795 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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