Document Detail


CT appearance of pulmonary tuberculosis in diabetic and immunocompromised patients: comparison with patients who had no underlying disease.
MedLine Citation:
PMID:  1442377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It has been stated, but not adequately assessed, that pulmonary tuberculosis in diabetic or immunocompromised patients often has an atypical pattern and distribution. To evaluate the CT features of pulmonary tuberculosis in diabetic or immunocompromised patients compared with patients without underlying disease, we performed this retrospective study. MATERIALS AND METHODS: We reviewed conventional CT scans (n = 100) and high-resolution CT scans (n = 16) of the chest in 110 adult patients with active postprimary tuberculosis. Seventy-one patients had no underlying disease, 31 had diabetes mellitus, and eight were immunocompromised. RESULTS: In patients who had no underlying disease, 44 had nodular opacities, 11 had consolidation, and 13 had consolidation with associated loss of volume. Characteristic features of tuberculosis in this group of patients included segmental distribution (97%), satellite lesions (93%), single cavity within any given lesion (95%), and tendency toward architectural distortion and loss of volume. In diabetic and immunocompromised patients, 15 had nodular opacities, seven had consolidation, and 15 had consolidation with associated loss of volume. Diabetic and immunocompromised patients had a high prevalence of nonsegmental distribution (30%) and multiple small cavities within any given lesion (44%). Unusual localization of tuberculosis, including disease confined to the basal segments of the lower lobes, anterior segment of the upper lobes, or right middle lobe, occurred equally in both groups (17% and 18%). CONCLUSION: We conclude that diabetic and immunocompromised patients have a higher prevalence of multiple cavities within any given lesion (p < .01) and of nonsegmental distribution (p < .01) than do patients without underlying disease.
Authors:
J Ikezoe; N Takeuchi; T Johkoh; N Kohno; N Tomiyama; T Kozuka; K Noma; E Ueda
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  159     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1992-12-18     Completed Date:  1992-12-18     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1175-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Osaka University Medical School, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Diabetes Complications*
Female
Humans
Immunocompromised Host*
Lung / radiography
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed*
Tuberculosis, Pulmonary / complications,  immunology,  radiography*

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