title: Unilateral lower lung field opacities on chest radiography: a comparison of the clinical manifestations of tuberculosis and pneumonia.
abstract: BACKGROUND
  The radiological manifestations of lower lung field (LLF) tuberculosis (LLFTB) are similar to those of LLF pneumonia (LLFP), making diagnosis challenging. The aim of this study was to determine if there are differences in the clinical manifestations of LLFTB and LLFP in patients with unilateral LLF opacities.
  
  
  METHODS
  We performed a retrospective review of patient records to identify those with unilateral LLF opacities who were subsequently diagnosed with LLFTB or LLFP. We compared demographics, clinical manifestations, hematological data, and radiographic findings between the groups of patients.
  
  
  RESULTS
  We identified 22 and 72 patients diagnosed with LLFTB and LLFP, respectively. Multivariate analysis revealed that age (odds ratio [OR]=1.05, 95% confidence interval [CI]=0.99-1.11, P=0.072), lack of fever>38°C (OR=9.04, 95% CI=1.69-48.40, P=0.001), duration of symptoms≥7 days (OR=4.57, 95% CI=1.09-19.26, P=0.038), and the lack of air bronchograms upon radiography (OR=12.08, 95% CI=1.98-73.64, P=0.007) were significant predictors of LLFTB in patients with LLF opacities. We used these predictors to construct a mathematical model for predicting LLFTB in patients with LLF opacities.
  
  
  CONCLUSIONS
  Our findings suggest that older age, prolonged duration of symptoms, lack of fever>38°C, and the absence of air bronchograms are more common in patients with LLFTB than patients with LLFP. These findings may help clinicians differentiate between LLFTB and LLFP and thus initiate timely and appropriate treatment.
authors.affiliation: Division of Chest Medicine, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanshiao Road, Changhua, Taiwan; School of Medicine, Chung Shan Medical University, Taiwan.
authors.forename: Ching-Hsiung
authors.initials: CH
authors.lastname: Lin
authors.forename: Tsung-Ming
authors.initials: TM
authors.lastname: Chen
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Chang
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Tsai
authors.forename: Woei-Horng
authors.initials: WH
authors.lastname: Chai
authors.forename: Jen-Ho
authors.initials: JH
authors.lastname: Wen
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy