Clinical and Radiological Presentation of Patients with Smear Positive Pulmonary Tuberculosis

Chest X-ray is an important diagnostic aid frequently used alongside microscopic smear of sputum for the confirmation of pulmonary tuberculosis (TB). However, there is a dearth of literature investigating the clinical and radiological pattern of sputum positive pulmonary TB among adults in Bangladesh. The current study explored these patterns in presentation. This descriptive cross-sectional study was conducted at outpatients in department of medicine of a tertiary care hospital. A total of 50 newly diagnosed adult cases of smear positive pulmonary TB attending at the Directly Observed Treatment Short-course (DOTS) corners were consecutively included. Informed written consent was taken before inclusion. Data were collected through face-to-face interview. Radiological presentation was explored using chest X-ray. Data were analyzed by SPSS version 26.0. The average age of patients was 41.0±17.12 years and majority were male (78.0%). The most prevalent respiratory symptom was cough (80.0%) followed by constitutional symptom like fever (70.0%) and weight loss (72.0%). Wasting was the predominant sign (60.0%). Radiologically both lungs were involved in 32.0%, left lung were involved in 30.0% cases and right lung were involved in 26.0% of cases. Twelve percent (12.0%) of patients had normal chest X-ray. Upper zone involvement was commonly observed in this study's patients (66.0%). The predominant pattern was consolidation (46.0%) followed by fibrosis (26.0%), nodular opacity (12.0%), collapse (10.0%), cavity (6.0%), pleural effusion (2.0%) and bronchiectasis (2.0%). Findings of this study would help familiarize and identify the common clinical and radiological presentations of sputum positive pulmonary TB patients in day-to-day practice.