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Abacillary pulmonary tuberculosis.

J Nørregaard1, T Heckscher, K Viskum

  • 1Department of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark.

Tubercle
|March 1, 1990
PubMed
Summary
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In a low tuberculosis incidence area, patients with chest X-ray infiltrates but negative sputum smears benefited from chemotherapy. Untreated patients progressed to culture-positive tuberculosis, while treated patients did not.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Clinical Research

Background:

  • Tuberculosis diagnosis can be challenging in low-incidence settings.
  • Sputum smear negativity does not always exclude tuberculosis.
  • Pulmonary infiltrates on chest X-ray warrant further investigation.

Purpose of the Study:

  • To evaluate the benefit of chemotherapy in patients with suspected tuberculosis and negative sputum smears.
  • To assess the natural progression of undiagnosed tuberculosis in this patient group.

Main Methods:

  • Prospective randomized study in Copenhagen.
  • Inclusion of 72 patients with pulmonary infiltrates and negative sputum smears.
  • Randomization of 50 patients into chemotherapy or untreated control groups.

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Main Results:

  • 22 patients (30.6%) initially had positive cultures and received treatment.
  • Among 28 untreated controls, 8 (29%) later became culture-positive for Mycobacterium tuberculosis.
  • None of the 22 treated patients developed culture-positive tuberculosis during 5-year follow-up.

Conclusions:

  • Chemotherapy is beneficial for patients with suspected tuberculosis and negative sputum smears.
  • Delaying or withholding treatment can lead to culture-positive tuberculosis.
  • Early diagnosis and treatment are crucial even in low-incidence settings.