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

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

scholarly journals Spectrum Of Chest X-Ray Findings Among Human Immunodeficiency Virus Positive Individuals In A Nigerian Tertiary Hospital

2014 ◽  
Vol 10 (2) ◽  
pp. 27-34 ◽  
Author(s):  
Rachael Adeyanju Akinola ◽  
TM Balogun ◽  
AA Adeniyi ◽  
JAA Onakoya ◽  
IO Fabeyibi
Keyword(s):  
Immune System ◽  
Teaching Hospital ◽  
Cd4 Count ◽  
University Teaching ◽  
Hiv Positive ◽  
X Rays ◽  
Cd4 Counts ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray

Introduction: Human immunodefi ciency virus infection damages the immune system making those affected more susceptible to opportunistic infections and malignancies which are common in the chest. This study sought to determine the pattern of chest X-ray lesions and the corresponding CD4 counts of HIV positive patients reporting in the antiretroviral clinic of this teaching hospital for the fi rst time. Methodology: Consecutive HIV positive patients that attended the antiretroviral clinic of the Lagos State University Teaching Hospital, (LASUTH) from September 2009 to January 2011 were recruited. Their chest x-rays were assessed for the presence of pulmonary lesions and baseline CD 4 counts were done to assess their degree of immunosuppression. Data were analyzed using the Statistical Package for Social Sciences, version 16.0. Results: There were 211 subjects, 151 females and 60 males with a M:F ratio of 1:2.5 The mean age of participants was 36.5±11.9. Mean baseline CD4 count for the subjects was 279±220.7 cells/mm3. Almost two thirds (64.9%) cases had normal chest x-rays with their mean CD4 count as 277.65±228.54 cells/mm3. The commonest lesions seen in the lungs include pulmonary infi ltrations, 55 (26.1%), cardiomegaly, 24 (11.4%), pulmonary consolidation, 21 (10%) and lymphadenopathy, 14 (6.6%). The commonest radiological diagnosis made were Atypical pneumonitis, 39 (18.5%), pulmonary TB, 13 (6.2%), pneumonia 13 (6.2%) and cardiomegaly13 (6.2%) respectively.Patients with chest findings had lower mean CD4 counts, 239 cells/mm3 when compared to those without, 244 cells/mm3. Conclusion: Pulmonary infiltration was the commonest lesion, while the commonest diagnosis was atypical pneumonitis. Patients with chest x-ray lesions were found to have lower CD4 counts with probable worse destruction of their immune system. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2013; X(2); 27-34 DOI: http://dx.doi.org/10.3126/saarctb.v10i2.9710

HIV-TUBERCULOSIS: A STUDY OF CHEST X-RAY PATTERNS IN RELATION TO CD4 COUNT

2021 ◽  
pp. 10-12
Author(s):  
Abdhesh Kumar ◽  
Naveen Kumar ◽  
Kumar Sourav
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Hospital ◽  
Hiv Positive ◽  
Who Guidelines ◽  
X Ray ◽  
Ciency Virus ◽  
Chest X Ray ◽  
Radiological Patterns ◽  
High Index Of Suspicion ◽  
Ray Patterns

Background: Fight against human immunodeciency virus (HIV) is incomplete without addressing problems associated with difcult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in J.L.N.M.C.H Bhagalpur from april 2019 to january 2021 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Inltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Inltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory inltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement was higher than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIVpositive patients.

A STUDY OF CARDIAC MANIFESTATIONS IN PATIENTS WITH HIV/AIDS

2021 ◽  
Vol 9 (10) ◽  
pp. 411-422
Author(s):  
Ajay Bang ◽  
◽  
Deepti Deshmukh ◽  
Sanjay Raut ◽  
◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Cd4 Count ◽  
Hiv Positive ◽  
X Ray ◽  
Cardiac Abnormalities ◽  
Ventricular Diastolic Dysfunction ◽  
Chest X Ray ◽  
Cardiac Manifestations

Introduction:HIV/AIDS pandemic is evolving as a major public concern. Cardiovascular diseases are common in HIV-positive patients. Many patients without any symptoms or signs were found to have a cardiovascular disease on autopsy.It is expected that the risk of cardiovascular disease willrise in the following years due to the cardiovascular risk profile andincreased life expectancy of infected patients. Therefore,diagnosis andtherapy of HIV-associated cardiovascular diseases should be part of the evaluation and management of the HIV-positive patient. Objectives: To find out the frequency of cardiac manifestations on clinical examination, electrocardiography, chest X-ray, and echocardiographic examination. To assess the association of Cardiac abnormality with CD4 Count in patients with HIV/AIDS. Toevaluate the association between cardiac abnormalities with types and duration of antiretroviral therapy regimen (ART). Method:A total of 100 consecutive patients visiting ART OPD and admitted to our institute were examined for signs and symptoms of cardiovascular disease. All patients were evaluated with electrocardiography, chest X-ray, and 2 D echocardiography. CD4 count was measured for all patients using flowcytometry using a BD FACS Count system. Results:Out of 100 patients, 53% were male and 47% were female. Patients were divided into subgroups with CD4 count <200, 200-349, 350-499, and ≥500. The mean CD4 count was 403.62 ± 284.98. Prevalence of the cardiovascular abnormality on ECG, chest X-ray, and echocardiography were 74%, 10%, and 51% respectively. The left ventricular systolic dysfunction was the most common finding in our study with fractional shortening ≤25% in 34% of patients and LVEF <50% in 27% of patients followed by left ventricular diastolic function (26%), dilated cardiomyopathy (6%), pulmonary hypertension (4%), and regional wall motion abnormality (2%).Reduced LV ejection fraction (<50%) and left ventricular diastolic dysfunction were statistically significant in patients with CD4 count less than 200/mm3. Conclusion: In present study electrocardiographic, chest X-ray and echocardiographic abnormalities were present in 74%, 10% and 51% patients respectively. Cardiac abnormalities such as QTc prolongation, LBBB, reduced left ventricular ejection fraction, and left ventricular diastolic dysfunction were more significantly higher in patients with CD4 count less than 200/mm3. We could not find any statistically significant difference in cardiac abnormalities in patients on different ART regimens. Further studies are required with a higher sample size.

THE IMPORTANCE OF CHEST-X-RAY (TIMIKA SCORE) TO PREDICT THE CLINICO-BACTERIOLOGICAL PROFILE OF PULMONARY TUBERCULOSIS PATIENTS

2021 ◽  
pp. 55-58
Author(s):  
Surinder Pal Singh ◽  
Harjinder Singh ◽  
Komal Deep Kaur ◽  
Kailash Meena ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Sputum Smear ◽  
Karnofsky Performance Score ◽  
Care Hospital ◽  
Duration Of Symptoms ◽  
Cavitary Lesion ◽  
X Ray ◽  
Chest X Ray

Introduction: Chest x-ray (CXR) is the primary modality for diagnosis and severity assessment and monitoring the ATT response in pulmonary tuberculosis (PTB). The aim of our study was to determine the correlation between the radiographic involvement of disease on CXR based on Timika CXR score with the clinically and bacteriological specications at diagnosis and initiation of ATT in sputum smear-positive PTB patients. Material And Method: A cross-sectional study was conducted in the Department of Pulmonary Medicine, a tertiary care hospital, Punjab, from January to June 2020. Seventy new sputum smear-positive cases of PTB were included. At the time of diagnosis, the patient's baseline test, clinical signs and symptoms were evaluated using TB scores I, II, Karnofsky performance score (KPS), and body mass index (BMI). Two chest physicians, according to the Timika CXR score, evaluated the CXR of each patient Independently. Result: Cavitary lesion on CXR resulted in a signicantly higher Timika score associated with higher Mycobacterial load in sputum grading compared to non-cavitary disease. 55.17% of patients with CXR score ≥71 had statistically signicant higher baseline sputum grading compared to 9.76% of patients with CXR ≤ 71. Higher Timika CXR score ≥ 71 was signicantly associated with a longer mean duration of symptoms, lower BMI, higher TB score, lower KPS at baseline, higher ESR, low hemoglobin, low serum albumin. Discussion: The study shows that Timika CXR score signicantly correlates with radiographic involvement and extent of disease severity on CXR with the clinically and bacteriological prole of PTB patients, which a pulmonologist can use in a medical practice. A Higher CXR Timika score is associated with the patient's poor clinical condition and the severity of the disease. Cavitary lesion on CXR associated with higher sputum smear grading. It is observed that the Timika CXR score can be used to identify the PTB patients at risk of treatment failure for their more aggressive management.

scholarly journals HUBUNGAN GAMBARAN FOTO TORAKS DAN UJI TUBERKULIN PADA ANAK DENGAN DIAGNOSIS TUBERKULOSIS PARU DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE JANUARI 2012 – DESEMBER 2012

e-CliniC ◽  
2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Alfa G. A. Poluan
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tuberculin Test ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Cross Sectional Design ◽  
Tuberculosis In Children ◽  
The Relationship ◽  
Global Health Problem ◽  
Research Analysis

Abstrak: Tuberkulosis (TB) masih menjadi masalah kesehatan dunia yang utama sampai sekarang. Menurut WHO, Indonesia masih menjadi negara dengan peringkat keempat sebagai penyumbang TB terbesar dengan 400-500 ribu kasus. WHO melaporkan bahwa ada sekitar 327.000 kasus baru TB pada anak dengan usia <15 tahun di seluruh dunia, dan sekitar 65.000 anak meninggal karena TB setiap tahun. Dalam mendiagnosis TB anak perlu dilakukan pemeriksaan uji tuberkulin dan foto toraks. Tujuan penelitian ini adalah untuk mengetahui hubungan gambaran foto toraks dan uji tuberkulin pada anak dengan diagnosis tuberkulosis paru.  Penelitian ini dilakukan di RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2012 – Desember 2012. Penelitian ini bersifat analitik observasional menggunakan desain cross sectional dengan data retrospektif. Pengambilan sampel pada penelitian ini menggunakan teknik total sampling. Data yang dikumpulkan diolah dengan menggunakan uji korelasi Kendall’s tau-b. Dari hasil analisa data didapatkan nilai r= -0,408 dengan p= 0,046 (p<0,05). Nilai ini berarti bahwa ada hubungan negatif sedang antara gambaran foto toraks dan uji tuberkulin. Dengan demikian, pemeriksaan foto toraks dan uji tuberkulin harus dilakukan dalam membantu menegakkan diagnosis tuberkulosis paru pada anak. Kata kunci: Foto toraks, uji tuberkulin, tuberkulosis paru, anak    Abstract: Tuberculosis (TB) remains a major global health problem until now. According to WHO, Indonesia has ranked as the fourth largest contributor TB with 400-500 cases. WHO reports that there are approximately 327,000 new cases of TB in children aged <15 years old all over the world, and about 65,000 children die from TB every year. In diagnosing TB in children, tuberculin test and chest x-ray are necessary. The purpose of this research is to determine the relationship between a chest x-ray picture and tuberculin test in children diagnosed with pulmonary tuberculosis. This research was conducted in RSUP Prof. Dr. R. D. Kandou Manado in the period of January 2012 – December 2012. This was an observational analytic research using cross-sectional design with retrospective data. There were 25 children observed in this research. Analysis shows a negative correlation between radiographic picture and tuberculin test (r= -0.408; p= 0.046). Accordingly, chest x-ray examination and tuberculin test should be performed to help justify the diagnosis of pulmonary tuberculosis in children. Key Words: Chest X-ray, Tuberculin test, Pulmonary Tuberculosis, Children

scholarly journals Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray

2014 ◽  
Vol 6 (1) ◽  
pp. 64 ◽  
Author(s):  
Samantha Herath ◽  
Christopher Lewis
Keyword(s):  
Public Health ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Involvement ◽  
Extra Pulmonary Tuberculosis ◽  
Pulmonary Tb ◽  
X Ray ◽  
Normal Chest ◽  
Chest X Ray ◽  
Extra Pulmonary ◽  
Hiv Negative

INTRODUCTION: Recognition of pulmonary involvement in extra-pulmonary tuberculosis (TB) may be an important public health issue, as smear-negative pulmonary TB is responsible for about 17% of new infections. Pulmonary TB can be present despite a normal chest x-ray (CXR), even in human immunodeficiency virus (HIV)–negative patients. In this retrospective clinical audit, we reviewed a case series of HIV-negative patients with extra-pulmonary tuberculosis to identify the proportion with concurrent pulmonary TB despite an unremarkable CXR. METHODS: Clinical notes, microbiology results and CXR reports were reviewed from consecutive patients treated at Auckland City Hospital for extra-pulmonary TB from January 2007 to July 2010. RESULTS: Of the sample of 103 patients with extra-pulmonary TB, the majority of patients were born in an Asian country (n=70; 68%). The commonest presentation of extra-pulmonary TB was lymphadenopathy (n=51; 50%), followed by pleural (n=24; 23%) and bone (n=6; 6%) disease. Extra-pulmonary TB was diagnosed by biopsy or excision of the extra-pulmonary site in the majority (n=74; 72%), and by sputum testing alone in 26 (25%). The majority had CXR abnormalities (n=76; 74%). In the group with a normal CXR (n=27), 55% (n=15) had sputum cultures performed. In total, 18% (n=5) of patients with extra-pulmonary TB and a normal CXR had pulmonary TB, of whom two were smear positive. DISCUSSION: In patients with extra-pulmonary TB, sputum testing should be considered to detect concurrent pulmonary TB even if a CXR is normal, especially in immunosuppressed or symptomatic patients. This may aid diagnosis and determine infectivity and consequent public health action. KEYWORDS: Chest x-ray; sputum; tuberculosis; tuberculosis, pulmonary

scholarly journals A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis

Thorax ◽  
2010 ◽  
Vol 65 (10) ◽  
pp. 863-869 ◽  
Author(s):  
A. P. Ralph ◽  
M. Ardian ◽  
A. Wiguna ◽  
G. P. Maguire ◽  
N. G. Becker ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
X Ray ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Chest X Ray
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