Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings.
OBJECTIVE
The purpose of this work was to describe the radiologic findings of pulmonary tuberculosis in patients who presented with acute respiratory failure.


METHODS
We included patients who had newly diagnosed active pulmonary tuberculosis and who presented with acute respiratory failure. Initial chest radiographic (n = 17) and high-resolution CT (n = 11) findings of each patient were analyzed retrospectively.


RESULTS
Of 1,010 patients with active pulmonary tuberculosis, 17 patients (1.7%) presented with acute respiratory failure. Nine (53%) of the 17 patients died. The most common initial chest radiographic findings were small nodular lesions (16/17; 94%), consolidation (13/17; 76%), and ground-glass opacity (12/17; 70%). Eleven (69%) of 16 nodular lesions, 9 of 13 (69%) consolidations, and 10 of 12 (83%) ground-glass opacities were bilateral. On HRCT (n = 11), miliary micronodular lesions were seen in 6 patients (55%), whereas bronchogenic spread of tuberculosis with disseminated centrilobular nodules and tree-in-bud appearance was seen in 5 patients (45%). Diffuse areas of ground-glass attenuation were seen in all six patients with miliary nodules and four of five patients with bronchogenic spread of tuberculosis.


CONCLUSIONS
Patients with pulmonary tuberculosis occasionally present with acute respiratory failure. In this condition, chest radiograph most commonly shows bilateral small nodular lesions mixed with consolidation or ground-glass opacity, whereas HRCT demonstrates findings of miliary or bronchogenic disseminated tuberculosis with diffuse areas of ground-glass attenuation.
Department of Radiology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea.
D
D
Choi
K S
KS
Lee
G Y
GY
Suh
T S
TS
Kim
O J
OJ
Kwon
C H
CH
Rhee
J
J
Han
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012131:Respiratory Insufficiency / Q000209:etiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology