[Clinical predictors of infectious pulmonary tuberculosis.].
BACKGROUND
The immediate identification of infectious tuberculosis and implementation of effective isolation measures, are a priority of the national policies for disease control.


OBJECTIVE
To identify clinical predictor's factors related with sputum smear-positive, in patients with pulmonary tuberculosis diagnosis.


METHODS
This was a retrospective study involving 289 patients admitted consecutively with the diagnosis of tuberculosis (ICD-9-CM: 010-018) through the emergency department of a Central Hospital. The study was conducted from January 1999 to December 2005.


RESULTS
216 patients (74.7%) were identified with pulmonary tuberculosis: mean age 40.3 (SD 16.1); 77.8% males. Of these 179 (82%) were smear-positive and 157 (54.5%) had human immunodeficiency virus (HIV) co-infection. Of the 37 patients with sputum smearnegative 18 (48.6%) had culture positive. The clinical factors that were better related with sputum smear-positive were: cough with sputum (p = 0.031) and classic chest radiograph patterns, parenchymal consolidation (p < 0.001) and cavitation (p = 0.002). HIV co-infection wasn't associated with a higher risk of infectious tuberculosis.


CONCLUSIONS
Respiratory symptoms and classic patterns on chest radiograph, were clinical factors better related with a higher probability of sputum smear-positive. In these patients it is a good clinical practice to propose immediate isolation measures even before the results of sputum smear.
Silvestre
Joana
J
Serviço de Medicina III, Hospital São Francisco Xavier (CHLO), Lisboa.
Leitão
Ana
A
Fonseca
Cândida
C
Alberca
Dolores
D
Marques
Filipa
F
Abreu
Ana
A
Araújo
Inês
I
João
Isabel
I
Aleixo
Ana
A
Ceia
Fátima
F
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*