title: Tuberculous pneumonia: a study of 59 microbiologically confirmed cases.
abstract: OBJECTIVE
  To study the clinical, epidemiological, radiographic and endoscopic features of individuals with tuberculous pneumonia.
  
  
  METHODS
  We evaluated 2,828 consecutive tuberculosis patients treated at a public health center between December of 2005 and February of 2007. Of those, 59 (2.1%) had pulmonary involvement consistent with fistula between a lymph node and a bronchus.
  
  
  RESULTS
  Of the 59 patients studied, 43 (73%) were between 20 and 50 years of age, 31 (53%) were male, and 28 (47%) were Black. The most common symptoms were cough (in 100%), fever (in 88%), expectoration (in 81%), and weight loss (in 40%). Comorbidities were reported in 35 cases (59%), the most common being HIV infection (in 20%) and diabetes (in 15%). On chest X-rays, consolidation was observed, predominantly in the upper lobes (in 68%). The diagnostic confirmation (identification of AFB) was made through the sputum smear microscopy in the majority of the cases and by bronchoscopy (BAL examination or bronchial biopsy) in the remainder. Bronchial lesions were clearly indicative or suggestive of fistula in three cases and five cases, respectively.
  
  
  CONCLUSIONS
  Tuberculous pneumonia presents as acute respiratory infection, initiating with a dry cough that is followed by fever. Chest X-rays show alveolar consolidation. In most cases, tuberculous pneumonia was accompanied by at least one comorbid condition, the most common being HIV infection, and the etiological diagnosis was made through sputum smear microscopy for AFB. Bronchoscopy findings were indicative of bronchial fistula in eight cases (13%).
authors.affiliation: Graduate Program in Pulmonology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Jose
authors.initials: J
authors.lastname: Moreira
authors.forename: Jamila Belicanta
authors.initials: JB
authors.lastname: Fochesatto
authors.forename: Ana L
authors.initials: AL
authors.lastname: Moreira
authors.forename: Marisa
authors.initials: M
authors.lastname: Pereira
authors.forename: Nelson
authors.initials: N
authors.lastname: Porto
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011859:Radiography; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult