Radiographic manifestations of culture-positive pulmonary tuberculosis: cavitary or non-cavitary?
OBJECTIVE
To examine the radiographic pattern of patients with pulmonary tuberculosis (PTB) in Saudi Arabia and the relation of these findings to demographic and microbiological data.


METHODS
A retrospective hospital-based series of patients with culture-positive PTB.


RESULTS
Among 168 cases of culture-positive PTB identified, 97 (57.7%) were males and 71 females (42.3%); 136 (81%) were Saudis and 19% were non-Saudis. The mean age was 52.3 +/- 19.2 years: nine (5.4%) were children aged <or=18 years and 64 (38.1%) were adults aged >60 years. Overall, 121 (78%) had upper lobe infiltrates, 35 (19.7%) had cavitary lesions and 33 (19.6%) had both upper lobe infiltrate and cavitation. Lymphadenopathy and pleural effusion were each present in 11.3% of the patients. Patients aged >60 years were less likely to have upper lobe infiltrate (38/64, 59.4%) compared to children (7/9, 77.8%) and adults aged 19-60 years (76/95, 80%, P = 0.001). Diabetes mellitus was documented in 57/135 (42.2%) patients. There was no difference in the presence of upper lobe infiltrate and the presence of cavitation in patients with and without diabetes mellitus.


CONCLUSIONS
Cavitary or upper lobe infiltrate remains a common presentation of PTB. As patients aged >60 years often present with no cavitation and without upper lobe infiltrate, it is important to keep in mind the possibility of tuberculosis in this group of patients.
Al-Tawfiq
J A
JA
Internal Medicine Services Division, Dhahran Health Centre, Saudi Aramco Medical Services Organization, Saudi Aramco, Dhahran, Saudi Arabia. jaffar.tawfiq@aramco.com
Saadeh
B M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D011859:Radiography; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology; D055815:Young Adult
D000995:Antitubercular Agents; D007538:Isoniazid