Radiological difference between new sputum-positive and sputum-negative pulmonary tuberculosis

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonology

Background:

• Current pulmonary tuberculosis (PTB) diagnosis relies on sputum microscopy for acid-fast bacilli (AFB) and chest radiography.
• Identifying diverse radiological manifestations and their link to sputum findings can improve early PTB diagnosis and treatment.

Purpose of the Study:

• To compare chest radiograph features between sputum-positive and sputum-negative PTB patients.
• To investigate the association between radiological findings and sputum microscopy results in PTB.

Main Methods:

• Prospective observational study of 147 newly diagnosed PTB patients.
• Chest X-rays were independently reviewed by two radiologists.
• Statistical analysis using SPSS, including chi-squared and Student t-tests, with P < 0.05 considered significant.

Main Results:

• Patchy consolidation (78.94% vs 49.54%) and cavitation (36.84% vs 15.59%) were significantly more frequent in sputum-positive PTB (P < 0.05).
• Sputum-positive PTB showed a higher incidence on the left side (47.36% vs 27.52%, P < 0.05).
• While nodular shadows, cystic lesions, fibrosis, miliary shadows, and pleural effusion were observed more in sputum-negative PTB, these differences lacked statistical significance.

Conclusions:

• Chest X-ray findings of patchy infiltration and cavitation are more prevalent in sputum-positive PTB.
• Radiological patterns can help differentiate sputum-positive from sputum-negative PTB cases.