Clinical and Radiological Presentation of Patients with Smear Positive Pulmonary Tuberculosis.

Mymensingh medical journal : MMJ Pub Date : 2024-10-01
S M Noor, M M Ahmad, K M R Anwar, M F Chowdhury, M Sultana, M A Kader, M A S Khan
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Abstract

Chest X-ray is an important diagnostic aid frequently used alongside microscopic smear of sputum for the confirmation of pulmonary tuberculosis (TB). However, there is a dearth of literature investigating the clinical and radiological pattern of sputum positive pulmonary TB among adults in Bangladesh. The current study explored these patterns in presentation. This descriptive cross-sectional study was conducted at outpatients in department of medicine of a tertiary care hospital. A total of 50 newly diagnosed adult cases of smear positive pulmonary TB attending at the Directly Observed Treatment Short-course (DOTS) corners were consecutively included. Informed written consent was taken before inclusion. Data were collected through face-to-face interview. Radiological presentation was explored using chest X-ray. Data were analyzed by SPSS version 26.0. The average age of patients was 41.0±17.12 years and majority were male (78.0%). The most prevalent respiratory symptom was cough (80.0%) followed by constitutional symptom like fever (70.0%) and weight loss (72.0%). Wasting was the predominant sign (60.0%). Radiologically both lungs were involved in 32.0%, left lung were involved in 30.0% cases and right lung were involved in 26.0% of cases. Twelve percent (12.0%) of patients had normal chest X-ray. Upper zone involvement was commonly observed in this study's patients (66.0%). The predominant pattern was consolidation (46.0%) followed by fibrosis (26.0%), nodular opacity (12.0%), collapse (10.0%), cavity (6.0%), pleural effusion (2.0%) and bronchiectasis (2.0%). Findings of this study would help familiarize and identify the common clinical and radiological presentations of sputum positive pulmonary TB patients in day-to-day practice.

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涂片阳性肺结核患者的临床和放射学表现。
胸部 X 光片是一种重要的诊断辅助手段,经常与痰液显微涂片一起用于确诊肺结核(TB)。然而,在孟加拉国,调查痰液阳性肺结核的临床和放射学模式的文献非常缺乏。本研究探讨了这些表现模式。这项描述性横断面研究是在一家三甲医院内科的门诊病人中进行的。研究连续纳入了在短期直接观察治疗(DOTS)角就诊的 50 例新确诊涂片阳性肺结核成人病例。纳入前已获得知情的书面同意。通过面对面访谈收集数据。使用胸部 X 光检查放射学表现。数据采用 SPSS 26.0 版进行分析。患者平均年龄为(41.0±17.12)岁,大多数为男性(78.0%)。最常见的呼吸道症状是咳嗽(80.0%),其次是发烧(70.0%)和体重减轻(72.0%)等体征。消瘦是最主要的体征(60.0%)。32.0%的病例双肺受累,30.0%的病例左肺受累,26.0%的病例右肺受累。12%(12.0%)的患者胸部 X 光片正常。本研究观察到的患者中,66.0%的患者上肺受累。主要表现为合并症(46.0%),其次是纤维化(26.0%)、结节性不透明(12.0%)、塌陷(10.0%)、空洞(6.0%)、胸腔积液(2.0%)和支气管扩张(2.0%)。这项研究的结果有助于熟悉和识别痰液阳性肺结核患者在日常工作中常见的临床和放射学表现。
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