Recognising tuberculosis in the lower lung field: an age- and sex-matched controlled study.
OBJECTIVE
Tuberculosis (TB) can sometimes present with consolidation in the lower lung field. This study was conducted to compare the manifestations of lower-lung-field TB (LLFTB) and other pulmonary TB.


METHODS
All new culture-proven TB patients with lower-lung-field consolidation from July 2001 through December 2002 were included. Age- and sex-matched TB patients with upper lung involvement were selected as controls.


RESULTS
A total of 79 patients with LLFTB were included. Their mean age was 58.8 years; 46 were male. The clinical, radiographic and laboratory findings were similar in the LLFTB and the control groups, except that the LLFTB patients had less cavitation (P = 0.005). Patients with LLFTB were diagnosed (P = 0.051) and treated (P = 0.001) later than the control patients. The calibres of the trachea and both main bronchi were significantly smaller in the LLFTB group (P < 0.001). More patients with LLFTB developed segmental or lobar atelectasis during follow-up (P = 0.028).


CONCLUSIONS
The manifestations of LLFTB are non-specific. The lower-lung involvement, the lower incidence of cavitation and the higher probability of segmental or lobar atelectasis implied that LLFTB was primary TB. A small bronchial calibre probably contributed to its development.
Wang
J Y
JY
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
Hsueh
P R
PR
Lee
C H
CH
Chang
H C
HC
Lee
L N
LN
Liaw
Y S
YS
Yang
P C
PC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D013902:Radiography, Thoracic; D012737:Sex Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*