[Pulmonary tuberculosis in non-immunocompromised patients. Current radiologic features]

Area of Science:

• Radiology
• Pulmonology
• Infectious Diseases

Background:

• Tuberculosis (TB) diagnosis relies heavily on imaging, but atypical presentations can complicate interpretation.
• Understanding the radiographic patterns of primary and postprimary TB is crucial for timely diagnosis in adults.

Purpose of the Study:

• To analyze and describe the chest radiographic and CT scan findings in adult patients with proved tuberculosis.
• To differentiate imaging characteristics between primary and postprimary tuberculosis.
• To highlight potential diagnostic challenges posed by atypical TB presentations.

Main Methods:

• Retrospective analysis of chest radiography and CT scans from 64 adult patients with confirmed tuberculosis.
• Categorization of TB cases into primary (39 patients) and postprimary (25 patients).
• Detailed documentation of radiographic findings including consolidation patterns, lobe distribution, cavitation, pleural effusion, and adenopathy.

Main Results:

• Both primary and postprimary tuberculosis predominantly manifest as upper lobe consolidations.
• Cavitation was observed in 16/33 primary TB cases and 7/32 postprimary TB cases.
• Pleural effusion and intrathoracic adenopathies were common findings, particularly in primary TB.
• Atypical presentations like atelectasis and pleural effusion without parenchymal changes were noted, mimicking other diseases.

Conclusions:

• Upper lobe consolidation is a common radiographic feature for both primary and postprimary tuberculosis in adults.
• The presence of cavitations, pleural effusions, and adenopathies should prompt consideration of TB.
• Atypical radiographic patterns can delay diagnosis, emphasizing the need for high clinical suspicion.