| Diagnostic strategy for pulmonary tuberculosis in a low-incidence country: results of chest X-ray and sputum cultured for Mycobacterium tuberculosis. | |
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MedLine Citation:
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PMID: 9176646 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The referral centre of tuberculosis in the municipality of Copenhagen, Denmark was the setting for this study, which aimed to assess the diagnostic strategy (chest X-ray and clinical mycobacteriology) in pulmonary tuberculosis. Patient records and chest X-rays were examined for all patients who had sputum or gastric lavage examined for Mycobacterium tuberculosis (Mtb) from 1 January 1992 to 30 April 1994. All chest X-rays were re-evaluated by a trained lung specialist, who did not know the results of sputum culture. Evaluation was referred to one of seven X-ray categories, and compared to the results of culture. Culture of sputum or gastric lavage were positive for Mtb in 54 (14%) of 392 patients; in 61% of 59 patients with X-ray changes thought to be due to tuberculosis (TB); in 20% of 51 patients with X-ray changes compatible with TB; in 14% of 35 patients with previous TB and radiographically active TB; in 2% of 103 patients with previous TB, but not radiographically active TB; in 1% of 112 patients with X-ray changes thought to be due to other disease; and none out of 32 patients with normal X-ray. Even in this highly selected material, it is relatively expensive to find the very few cases of active TB in patients with chest X-ray changes not suspected to be due to TB. It is recommended that: (1) examination of sputum for Mtb should always be preceded by X-ray of the chest in a low-prevalence country; (2) routine culture of sputum for Mtb is restricted to patients with X-ray changes typical or compatible with active TB; and (3) exceptions to this general rule should be made on the basis of the individual's clinical history. |
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Authors:
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J T Wilcke; A Kok-Jensen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Respiratory medicine Volume: 91 ISSN: 0954-6111 ISO Abbreviation: Respir Med Publication Date: 1997 May |
Date Detail:
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Created Date: 1997-06-24 Completed Date: 1997-06-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8908438 Medline TA: Respir Med Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 281-5 Citation Subset: IM |
Affiliation:
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Department P of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Denmark Humans Lung / radiography Middle Aged Mycobacterium tuberculosis / isolation & purification* Sputum / microbiology* Tuberculosis, Pulmonary / diagnosis*, microbiology, radiography |
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