Clinical relevance of ground glass opacity in 105 patients with miliary tuberculosis.
BACKGROUND
After the application of chest computed tomography (CT), ground glass opacity (GGO) was introduced as one of major accompanying findings of miliary tuberculosis (MT) in addition to miliary nodules. However, little is known about whether GGO is associated with the clinical manifestations and outcomes of MT. Therefore, the present study examined the clinical relevance of GGO in patients with MT.


METHODS
Chest radiographs and CT scans of MT patients were retrospectively reviewed. Clinical manifestations and outcomes were compared in terms of the extent of GGO revealed by chest CT.


RESULTS
Confirmed 105 MT patients were included. GGO was observed in 70 (67%) patients. MT patients with an extent of GGO >50% (n = 21) had symptoms of shorter duration, more frequent dyspnea, and more pronounced changes in the levels of acute phase reactants. Miliary nodules were less discernible on CT in those with an extent of GGO >50%. MT patients with an extent of GGO >50% were significantly associated with a longer hospital stay (p = 0.02) and with acute respiratory failure (p < 0.001) than those with an extent of GGO ≤ 50%. However, mortality among MT patients was not associated with the extent of GGO.


CONCLUSIONS
MT patients with an extent of GGO >50% had more rapidly progressive manifestations and a greater potential for delayed diagnosis and poorer prognosis. Nevertheless, mortality was not higher in confirmed MT patients with an extent of GGO >50% than in those with an extent of GGO ≤ 50%.
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Jaehee
J
Lee
Department of Radiology, Kyungpook National University, School of Medicine, Daegu, South Korea.
Jae Kwang
JK
Lim
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Hyewon
H
Seo
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
So Yeon
SY
Lee
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Keum Ju
KJ
Choi
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Seung Soo
SS
Yoo
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Shin Yup
SY
Lee
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Seung Ick
SI
Cha
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea.
Jae Yong
JY
Park
Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea. Electronic address: kimch@knu.ac.kr.
Chang Ho
CH
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000000981:diagnostic imaging*; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*; D055815:Young Adult
Computed tomography; Ground glass opacity; Miliary tuberculosis