Frequency of Atypical Radiological Pattern of Pulmonary Tuberculosis in Adults and Elderly (Dissertation Based Article)

Abstract

Introduction:  Tuberculosis is one of the oldest dise-ases and one third of the world's population is affec-ted. Typical pattern (infiltration and or nodules with or without cavitations involving upper zone lung field) of pulmonary tuberculosis is the most common mode of radiological presentation in adults. There is a trend to-wards a relative increase in the unusual radiological presentations. This study was conducted to determine the frequency of atypical radiological trend of pulmo-nary tuberculosis in adults and elderly.

Subjects and Methods:  The objective of the study was to determine frequency of atypical radiological pattern of pulmonary tuberculosis in adults and elder-ly. It was a descriptive (case series) study and was conducted in the Department of Pulmonology, Nishtar Hospital Multan. The study duration was six months from 24 May 2006 to 23 November 2006. 300 patients presenting with pulmonary tuberculosis were selected. History and clinical examination was done. Relevant investigations and x-ray chest were carried out. Lesi-ons like infiltration with or without cavitation were localized in upper, middle and lower zones. Groups of patients with their x-ray findings in different zones were made and analyzed accordingly, data collected were entered in specific proforma.

Results:  205 (97.6%) adults and 85 (94.4%) elderly presented with cough while 205 (97.6%) adults and 75 (83.3%) elderly presented with fever. Out of 300 cases infiltration was found in 141 (46.19% vs 48.88%) young adult and elderly cases. There were 99 cases with nodule (35.71% vs 26.66%) and 60 cases had cavitation (18.09% vs 24.44%).

Conclusion:  There is a trend towards a relative incre-ase in the frequency of unusual radiological presenta-tions which is more common in elderly.

Key Words:  Pulmonary tuberculosis (PTB), Infiltra-tion, nodule, cavitation.