Clinical investigation of cavitary tuberculosis and tuberculous pneumonia.
BACKGROUND
[corrected] The radiographic characteristics of tuberculous pneumonia in adults are similar to primary tuberculosis that occurs in childhood, and upper lobe cavitary tuberculosis is the hallmark of postprimary tuberculosis. The purpose of this study was to investigate the factors associated with tuberculous pneumonia by making comparison with cavitary tuberculosis.


METHODS
The medical records and radiographic findings of patients with cavitary tuberculosis and tuberculous pneumonia, and who were diagnosed between March 2003 and February 2006, were analyzed retrospectively.


RESULTS
Forty patients had cavitary tuberculosis and sixteen patients had tuberculous pneumonia. Fever was more frequent for tuberculous pneumonia, whereas hemoptysis was more frequent for cavitary tuberculosis. The duration of symptoms before visiting the hospital was shorter, but the diagnosis after admission was more delayed for tuberculous pneumonia patients than for cavitary tuberculosis patients. The prevalence of underlying comorbidities such cancer, diabetes, alcoholism and long-term steroid use was not different between the two groups. The patients with tuberculous pneumonia were older and they had lower levels of serum albumin and hemoglobin than those with cavitary tuberculosis. The patients with tuberculous pneumonia showed a tendency to have more frequent endobronchial lesion. Tuberculous pneumonia occurred in any lobe, whereas the majority of cavitary tuberculosis patients had upper lung lesion, but the prevalence of lymphadenopathy, pleural effusion and previous tuberculosis scar was not different between the two groups.


CONCLUSIONS
Older age, a lower level of serum albumin and hemoglobin and a random distribution of lesion were associated with tuberculosis pneumonia as compared with cavitary tuberculosis. These findings suggest that the pathogenesis of tuberculous pneumonia might be different from that of cavitary tuberculosis.
Lee
Ki Man
KM
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. kimlee@chungbuk.ac.kr
Choe
Kang Hyeon
KH
Kim
Sung Jin
SJ
D000328:Adult; D001706:Biopsy; D001999:Bronchoscopy; D003937:Diagnosis, Differential; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D018410:Pneumonia, Bacterial / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology
D006454:Hemoglobins; D012709:Serum Albumin