Adult-onset pulmonary tuberculosis.

Area of Science:

• Pulmonology
• Infectious Diseases
• Radiology

Background:

• Tuberculosis (TB) epidemiology is shifting, with increasing adult-onset cases.
• Decreased childhood exposure and a rise in immunocompromised individuals contribute to this trend.
• Adult TB often differs from classic childhood presentations.

Purpose of the Study:

• To characterize the clinical and radiographic features of adult-onset primary tuberculosis.
• To highlight diagnostic challenges and management implications for radiologists and clinicians.

Main Methods:

• Retrospective review of medical records and radiographs from 103 adult patients with primary tuberculosis.
• Analysis of presenting symptoms, radiographic findings, and complications.

Main Results:

• Adult TB frequently presents with delayed diagnosis.
• Radiographic findings include lower-lobe infiltrates, though upper lobes are also involved; adenopathy, cavitation, and tuberculoma are rare.
• Pleural effusion necessitates biopsy; complications include adult respiratory distress syndrome and disseminated intravascular coagulopathy.

Conclusions:

• Adult-onset TB requires heightened radiologist awareness for prompt diagnosis.
• Classic signs of childhood TB may be absent, necessitating a broader differential diagnosis.
• Early recognition improves patient outcomes and management strategies.