Document Detail


Diagnostic strategy for pulmonary tuberculosis in a low-incidence country: results of chest X-ray and sputum cultured for Mycobacterium tuberculosis.
MedLine Citation:
PMID:  9176646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J T Wilcke; A Kok-Jensen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiratory medicine     Volume:  91     ISSN:  0954-6111     ISO Abbreviation:  Respir Med     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-24     Completed Date:  1997-06-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  281-5     Citation Subset:  IM    
Affiliation:
Department P of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
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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