[Attitude toward patients with pulmonary pathological images supposed to be tuberculosis but without bacteriological...

In view of establishing an attitude toward patients with pathological pulmonary images, suspected of tuberculosis but without bacteriological confirmation, a study was organized in an area serviced by 9 offices of phthisiology. A total of 154 such cases were identified between 1st January and 30th April 1978. These were followed up and controlled by radiological as well as bacteriological examinations for a period of one year. The anti-tuberculous treatment did not have to be applied except when the diagnosis was confirmed as tuberculosis. In 11 of the patients (7,1%) the diagnosis was made from the start, and it was established that they had active, non-bacillary pulmonary tuberculosis. In another 49 patients (31,8%) the suspicion was abandoned, and tuberculosis. In another 49 patients (31,8%) the suspicion was abandoned, and various other pulmonary affections, but not tuberculosis, were diagnosed, either of chronic or acute type. The remaining 94 patients (61,1%) remained suspected of tuberculosis. In 16 of them, in spite of the provisions made in the protocol of the study, anti-tuberculous treatment was applied. Of them 3 died of pulmonary cancers during the follow-up. The remaining suspects were not treated. Five of them (7,3%) have developed active tuberculosis, bacteriologically confirmed in 3 of the cases. The rest had a normal eventless evolution. The authors consider the careful investigation and follow-up of suspects for a period of one year as the most correct attitude in such cases.