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 The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Camilla E. Le Roux ◽  
Sucari S.C. Vlok
Keyword(s):  
South Africa ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Communicable Disease ◽  
Diagnostic Dilemma ◽  
Extra Pulmonary Tuberculosis ◽  
Immunodeficiency Virus ◽  
Normal Chest Radiograph ◽  
Normal Chest ◽  
Extra Pulmonary

Extra-pulmonary tuberculosis (EPTB), caused by Mycobacterium tuberculosis, is the leading cause of communicable disease-related deaths in people with human immunodeficiency virus (HIV) worldwide and in South Africa. Mycobacterium tuberculosis disseminates haematogenously from an active primary lung focus and may affect extra-pulmonary sites in up to 15% of patients. Extra-pulmonary TB may present with a normal chest radiograph, which often causes a significant diagnostic dilemma. This review describes the main sites of involvement in EPTB, which is illustrated by local imaging examples.

scholarly journals Novel Method for Detection of Sars-COV2 Using Chest X-Ray Images

2021 ◽  
pp. 145-149
Author(s):  
Mrs Tejaswini ML ◽  
Ashwni H ◽  
Chandana N ◽  
Harshitha BR ◽  
Nagashree HN
Keyword(s):  
Public Health ◽  
Health Sector ◽  
Cost Effective ◽  
Fast Response ◽  
Training Data ◽  
X Ray ◽  
Public Areas ◽  
Normal Chest ◽  
Chest X Ray ◽  
Radiograph Image

A coronavirus have a great impact on a public health globally. Real time PCR s used for pathological testing but that result in false test result this impact made to exploration of alternate method for testing [1]. The detection of coronavirus 2 using chest X-ray image is anlifesaving property. By using chest X-ray coronavirus can identified are cost effective and its available on every public health sector rural clinic hospital. Deep learning –based chest radiograph classification (DL-CRC) frame are used to distinguish the COVID-19 cases and normal cases will high accuracy. The pre-trained image database used for large training sets to have pre- trained weights .The training data consisting covid chest X-ray image and normal chest X-ray image and fed into customized convolution neural network (CNN) model in DL-CRC wear masks in public areas is a major protection for people .The classification implies that it can efficiently detection COVID-19 from radiograph image for provide a reliable and fast response of COVID-19 infection in the lung.

scholarly journals Factors Associated with Participation in Pulmonary Tuberculosis Screening Using Chest X-Ray among Diabetes Mellitus Type II Patients in Denpasar, Bali, Indonesia

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
I Gusti Ngurah Edi Putra ◽  
Putu Ayu Swandewi Astuti ◽  
I Ketut Suarjana ◽  
Ketut Hari Mulyawan ◽  
I Made Kerta Duana ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Insurance ◽  
Pulmonary Tuberculosis ◽  
Health Provider ◽  
Type Ii ◽  
Cross Sectional ◽  
Pulmonary Tb ◽  
X Ray ◽  
Factors Associated ◽  
Chest X Ray

Diabetes mellitus (DM) increases the risk of developing pulmonary tuberculosis (TB) disease. Therefore, pulmonary TB screening among DM patients is essential. This study aimed to identify factors associated with participation of DM type II patients in pulmonary TB screening using chest X-ray. This was a cross-sectional analytic study and was part of TB-DM screening study in Denpasar, Bali, Indonesia. The sample consisted of 365 DM type II patients selected by quota sampling among DM type II patients joining the screening program from January until March 2016 in 11 public health centres in Denpasar. Data were collected via structured interviews. The contributing factors were determined by modified Poisson regression test for cross-sectional data. From the findings, less than half (45.48%) of DM type II patients participated in chest X-ray examination for TB. Factors associated with participation in pulmonary TB screening were having a higher educational level [APR = 1.34, 95% CI (1.07–1.67)], having family member who developed pulmonary TB disease [APR = 1.47, 95% CI (1.12–1.93)], the travel time to referral hospital for screening being ≤ 15 minutes [APR = 1.6, 95% CI (1.26–2.03)], having health insurance [APR = 2.69, 95% CI (1.10–6.56)], and receiving good support from health provider [APR = 1.35, 95% CI (1.06–1.70)]. Therefore, training for health provider on providing counselling, involvement of family members in screening process, and improving the health insurance coverage and referral system are worth considering.

Usefulness of GeneXpert MTB/RIF in the diagnosis of extra-pulmonary tuberculosis

2021 ◽  
Vol 11 (2) ◽  
pp. 121-124
Author(s):  
Nasreen Islam ◽  
Mohammad Delwar Hossain ◽  
Muhammad Abdur Rahim ◽  
Jamal Uddin Ahmed ◽  
Muhammad Kamrul Amin ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pleural Fluid ◽  
Past History ◽  
Gastric Lavage ◽  
Extra Pulmonary Tuberculosis ◽  
Pulmonary Tb ◽  
Male Predominance ◽  
Bacteriological Diagnosis ◽  
Extra Pulmonary ◽  
Tracheal Aspirates

Background: Diagnosis of extra-pulmonary tuberculosis (TB) is often delayed because of diverse clinical presentations and difficulties in establishing the bacteriological diagnosis. This study aimed to evaluate usefulness of GeneXpert MTB/RIF in the diagnosis of extra-pulmonary TB in Bangladeshi patients. Methods: This cross-sectional study was done in BIRDEM General Hospital, Dhaka, Bangladesh from 2013 to 2016 as a part of Bangladesh Diabetic Somiti (BADAS)-USAID-TB Care-II project. Representative samples from 590 clinically suspected extra-pulmonary TB cases were tested for GeneXpert MTB/RIF along with conventional methods. Results: Total patients were 590 [mean age 43.9 (range 1-95) years] with male predominance (326, 55.3%). Most (513, 86.9%) patients were diabetic and new (574, 97.3%) TB suspects; while 16 (2.7%) patients had past history of TB. Common samples were pleural fluid (125, 21.2%), urine (110, 18.6%), cerebrospinal fluid (CSF) (91, 15.4%), pus (82, 13.9%), tracheal aspirates (57, 9.7%), ascitic fluid (45, 7.6%), gastric lavage (31, 5.3%), broncho-alveolar lavage (BAL) (18, 3.1%), lymph node aspirates (11, 1.9%) and synovial fluid (8, 1.4%). Among 590 samples, 68 (11.5%) were positive for Mycobacterium tuberculosis. Diagnostic yield was common for lymph nodes (4/7, 57.1%), pus (25/82, 30.5%), BAL (4/18, 22.2%), tracheal aspirates (8/57, 14.0%), urine (7/110, 6.4%), CSF (6/91, 6.6%) and pleural fluid (7/125, 5.6%). Of the 68 GeneXpert MTB/RIF positive samples, 52 (76.1%) were rifampicin sensitive, 16 (23.9%) showed intermediate sensitivity and none of the samples was resistant to rifampicin. Conclusions: GeneXpert MTB/RIF appeared as useful tool for diagnosing extra-pulmonary TB. Birdem Med J 2021; 11(2): 121-124

scholarly journals Diagnostic accuracy of computer aided reading of chest x-ray in screening for pulmonary tuberculosis in comparison with Gene-Xpert

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Tahira Nishtar ◽  
Shamsullah Burki ◽  
Fatima Sultan Ahmad ◽  
Tabish Ahmad
Keyword(s):  
Pulmonary Tuberculosis ◽  
Diagnostic Accuracy ◽  
World Health ◽  
Computer Aided Detection ◽  
Pulmonary Tb ◽  
High Burden ◽  
X Ray ◽  
Computer Aided ◽  
Chest X Ray ◽  
Computer Aided Reading

Background & Objectives: Pakistan ranked fifth amongst 22 high-burden Tuberculosis countries, and it is  an epidemic in Pakistan, hence screening is performed nationally, as part of the ambitious ZERO TB drive. Our objective was to assess the diagnostic accuracy of Computer Aided Detection (CAD4TB) software on chest Xray in screening for pulmonary tuberculosis in comparison with gene-Xpert. Methods: The study was conducted by Radiology Department Lady Reading Hospital Peshawar in affiliation with Indus Hospital network over a period of one year. Screening was done by using mobile Xray unit equipped with CAD4TB software with scoring system. All of those having score of more than 70 and few selected cases with strong clinical suspicion but score of less than 70 were referred to dedicated TB clinic for Gene-Xpert analysis. Results: Among 26,997 individuals screened, 2617 (9.7%) individuals were found presumptive for pulmonary TB. Sputum samples for Gene-Xpert were obtained in 2100 (80.24%) individuals, out of which 1825 (86.9%) were presumptive for pulmonary TB on CAD4TB only. Gene-Xpert was positive in 159 (8.7%) patients and negative in 1,666(91.3%). Sensitivity and specificity of CAD4TB and symptomatology with threshold score of ≥70 was 83.2% and 12.7% respectively keeping Gene-Xpert as gold standard. Conclusion: Combination of chest X-ray analysis by CAD4TB and symptomatology is of immense value to screen a large population at risk in a developing high burden country. It is significantly a more effective tool for screening and early diagnosis of TB in individuals, who would otherwise go undiagnosed. Abbreviations: TB = Tuberculosis, WHO = World Health Organization, CAD4TB = Computer aided detection for tuberculosis, CXR = Chest X-Ray, CAR = Computer aided reading. doi: https://doi.org/10.12669/pjms.38.1.4531 How to cite this:Nishtar T, Burki S, Ahmad FS, Ahmad T. Diagnostic accuracy of computer aided reading of chest x-ray in screening for pulmonary tuberculosis in comparison with Gene-Xpert. Pak J Med Sci. 2022;38(1):---------.   doi: https://doi.org/10.12669/pjms.38.1.4531 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.

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 Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis

2021 ◽  
Vol 5 (10) ◽  
pp. 903-910
Author(s):  
Ricky Septafianty ◽  
Anita Widyoningroem ◽  
M. Yamin S. S ◽  
Rosy Setiawati ◽  
Soedarsono
Keyword(s):  
Pulmonary Tuberculosis ◽  
Multidrug Resistant ◽  
X Rays ◽  
Pulmonary Tb ◽  
X Ray ◽  
Pleural Thickening ◽  
Significant Difference ◽  
Record Data ◽  
Mdr Tb ◽  
Chest X Ray

Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis. Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category. Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found. Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.

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