Characteristics of Patients with Smear-Negative Pulmonary Tuberculosis (TB) in a Region with High TB and HIV Prevalence
INTRODUCTION:
Smear-negative
pulmonary TB (SNPT) represents 30-60% of all pulmonary TB cases. The mortality
of these patients can reach 25% in populations with high prevalence of HIV
infection, and 10-20% of TB transmission at the population level are
attributable to SNPT cases.
METHODS:
We
conducted a retrospective study to evaluate epidemiological, clinical, and
radiological characteristics of patients with SNPT and to compare these with
patients who were diagnosed as having smear-positive pulmonary TB (SPPT). All
adult patients (≥ 18 years old) with a positive culture for Mycobacterium
tuberculosis, and a diagnosis of pulmonary TB were included in the study.
RESULTS:
198
patients met the inclusion criteria (positive culture for Mycobacterium
tuberculosis) and were included in the analysis. Of these patients, 69 (34.8%)
were smear positive (SPPT) and 129 (65.2%) were smear negative (SNPT). In
univariate analysis, cough, dyspnea, and hemoptysis were less frequent in SNPT
patients in comparison with SPPT patients. In a multivariate model, having no
cough and no radiographic pattern typical of TB were the characteristics
independently associated with a diagnosis of SNPT.
CONCLUSIONS:
We
found a very high prevalence of SNPT among patients with TB in a setting with
high TB and HIV prevalence. The absence of cough in the presence of other
symptoms suggestive of TB, and having no radiographic pattern typical of TB
where independent predictors of SNPT.
Below: Characteristics of patients with SNPT and SPPT
- 1Programa de Pós-Graduação em Ciências Pneumológicas, UFRGS, Porto Alegre, Brazil.
- 2Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- 3Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
- PLoS One. 2016 Jan 25;11(1):e0147933. doi: 10.1371/journal.pone.0147933. eCollection 2016.
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