scholarly journals Active pulmonary tuberculosis: something old, something new, something borrowed, something blue

2022 ◽  
Vol 13 (1) ◽  
Author(s):  
Maria T. A. Wetscherek ◽  
Timothy J. Sadler ◽  
Janice Y. J. Lee ◽  
Sumit Karia ◽  
Judith L. Babar
Keyword(s):  
Pulmonary Tuberculosis ◽  
Age Groups ◽  
Diagnostic Value ◽  
Special Focus ◽  
Active Pulmonary Tuberculosis ◽  
New Concepts ◽  
The Galaxy ◽  
Global Health Issue ◽  
Reversed Halo Sign ◽  
Negative Sputum

AbstractTuberculosis remains a major global health issue affecting all countries and age groups. Radiology plays a crucial role in the diagnosis and management of pulmonary tuberculosis (PTB). This review aims to improve understanding and diagnostic value of imaging in PTB. We present the old, well-established findings ranging from primary TB to the common appearances of post-primary TB, including dissemination with tree-in-bud nodularity, haematogenous dissemination with miliary nodules and lymphatic dissemination. We discuss new concepts in active PTB with special focus on imaging findings in immunocompromised individuals. We illustrate PTB appearances borrowed from other diseases in which the signs were initially described: the reversed halo sign, the galaxy sign and the cluster sign. There are several radiological signs that have been shown to correlate with positive or negative sputum smears, and radiologists should be aware of these signs as they play an important role in guiding the need for isolation and empirical anti-tuberculous therapy.

scholarly journals Reversed halo sign in active pulmonary tuberculosis

2014 ◽  
Vol 2014 (jul25 1) ◽  
pp. bcr2013202981-bcr2013202981 ◽  
Author(s):  
L. Nattusamy ◽  
K. Madan ◽  
A. S. Bhalla ◽  
R. Guleria
Keyword(s):  
Pulmonary Tuberculosis ◽  
Active Pulmonary Tuberculosis ◽  
Halo Sign ◽  
Reversed Halo Sign

scholarly journals Unilateral Nonconfluent Cluster of Micronodules: Atypical Radiologic Appearance of Pulmonary Tuberculosis in an Immunocompetent Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Bushra Johari ◽  
Mohammad Hanafiah
Keyword(s):  
Pulmonary Tuberculosis ◽  
Urine Culture ◽  
Left Kidney ◽  
Lung Parenchyma ◽  
Immunocompetent Patient ◽  
Duplex System ◽  
Genitourinary Tuberculosis ◽  
Active Pulmonary Tuberculosis ◽  
Negative Sputum ◽  
The Right

Active pulmonary tuberculosis involving the lung parenchyma is typically seen on CT as consolidation, centrilobular nodules with tree-in-bud branching, cavitating lesions, and miliary nodules. However, some atypical CT patterns of granulomatous disease including tuberculosis have been recently described, namely, clusters of nodules without confluence or with confluence. We present a case of a patient who was found to have nonconfluent clusters of micronodules in the right lung with negative sputum culture for tuberculosis. There were also incidental findings of the partial duplex system of the left kidney with mild-to-moderate hydronephrosis in the lower moiety with proximal hydroureter. The urine culture was then positive for mycobacterium tuberculosis; hence, he was commenced on antituberculous medications. A repeated CT scan revealed significant improvement of the aforementioned clusters of micronodules and left hydronephrosis. In the present case, we would like to highlight the atypical appearances of pulmonary tuberculosis in the form of nonconfluent micronodules on HRCT despite negative sputum workup, with the concurrent active genitourinary tuberculosis.

scholarly journals New possibilities to diagnose pulmonary tuberculosis at a pulmonology inpatient department

2019 ◽  
Vol 29 (3) ◽  
pp. 321-326
Author(s):  
E. A. Borodulina ◽  
B. E. Borodulin ◽  
A. T. In’kova ◽  
E. S. Vdoushkina ◽  
L. V. Povalyayeva
Keyword(s):  
Pulmonary Tuberculosis ◽  
Lavage Fluid ◽  
Diagnostic Value ◽  
Molecular Methods ◽  
Smear Microscopy ◽  
Molecular Testing ◽  
Chest X Ray ◽  
Negative Sputum ◽  
Mycobacteria Tuberculosis ◽  
Inpatient Department

The aim of the study was to investigate new methods for pulmonary tuberculosis (TB) detection at a pulmonology inpatient department.Methods. Pulmonary TB cases (n = 49) newly diagnosed at a pulmonology department of a hospital were involved in the study; among them, 69.4% of patients were infected with human immunodeficiency virus (HIV). All patients were asked if he/she had previously contacted with other TB patients, and if he/she was diagnosed with TB previously. The patients were also about family history. Posteroanterior and lateral chest X-ray and laboratory analyses were performed in all patients. Mycobacteria tuberculosis (MBT) were searched using smear microscopy, GeneXpert MTB/RIF molecular method and culturing (BACTEC MGIT) of sputum and bronchoalveolar lavage fluid (BALF) obtained during bronchoscopy. Patients with positive results only were included in the analysis in order to investigate and to compare diagnostic value of the methods.Results. Questioning patients at admission was useful to diagnose TB in 4% of patients. Sputum smears were positive in 12 patients (27.3%). BALF was obtained in 18 patients (36.7%); among them, MBT was identified in 52 (5%). Molecular testing was positive in all 49 patients (100%); among them, BACTEC MGIT culturing yielded MBT in 48 patients (97.9%). In patients with negative sputum smears during the first 3 days after admission, GeneXpert required 10.4 ± 5.3 days.Conclusion. GeneXpert method was highly useful to diagnose TB and was comparable with BACTEC. Routine sputum and BALF smear microscopy was significantly less rapid and less sensitive method. The diagnostic accuracy could be increased with the use of molecular methods in patients with negative sputum smears obtained at a general hospital. Therefore, molecular methods could be used in patients highly suspected for TB. 

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

2008 ◽  
Vol 15 (6) ◽  
pp. 1028-1030 ◽  
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.

Reversed Halo Sign in Active Pulmonary Tuberculosis: Criteria for Differentiation From Cryptogenic Organizing Pneumonia

2011 ◽  
Vol 197 (6) ◽  
pp. 1324-1327 ◽  
Author(s):  
Edson Marchiori ◽  
Gláucia Zanetti ◽  
Klaus Loureiro Irion ◽  
Luiz Felipe Nobre ◽  
Bruno Hochhegger ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Organizing Pneumonia ◽  
Cryptogenic Organizing Pneumonia ◽  
Active Pulmonary Tuberculosis ◽  
Halo Sign ◽  
Reversed Halo Sign

scholarly journals Diagnostic Value of Spiral CT Chest Enhanced Scan in Adult with Active Pulmonary Tuberculosis

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Ruishu Wang
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiography ◽  
Detection Rate ◽  
Spiral Ct ◽  
Diagnostic Value ◽  
X Ray ◽  
Active Pulmonary Tuberculosis ◽  
Chest X Ray ◽  
Tuberculosis Diagnosis ◽  
The Difference

Aim: To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis. Methods: The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed. All patients underwent conventional chest radiography and spiral CT chest enhanced scan. The number of tuberculosis diagnosis, the detection rate of special site lesions, and the detection rate of active pulmonary tuberculosis signs by the two methods were compared. Results: In 60 patients, the pathological results confirmed the existence of 75 tuberculosis lesions. The detection rate of spiral CT was 98.67%, which was not statistically significant compared with the detection rate of 92.00% (P>0.05) in the conventional chest X-ray. The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%, which was significantly higher than that of conventional chest X-ray of 7.69%, and the accuracy rate of active pulmonary tuberculosis signs was 98.85% higher than that of conventional chest X-ray of 79.31%. P<0.05). The difference was statistically significant (P<0.05). Conclusion: Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography, but also accurately determine active pulmonary tuberculosis in adults, which is of high diagnostic value.

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