Clinical and imaging factors that can predict contagiousness of pulmonary tuberculosis

BMC Pulmonary Medicine

Research

Florian Meyer-Oschatz¹  Wolfram Windisch²  Bernhard Schaaf³  Markus Unnewehr⁴  Hendrik Friederichs⁵ 

[1] Department of Anaesthesiology, Emergency Medicine, Intensive Care Medicine, Bundeswehrzentralkrankenhaus Koblenz, Rübenacher Straße 170, 56072, Koblenz, Germany;Faculty of Medicine, Universität Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany;Faculty of Health, Universität Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany;Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Ostmerheimer Str. 200, 51109, Köln, Germany;Faculty of Health, Universität Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany;Department of Respiratory Medicine, Infectious Diseases, Intensive Care Medicine, Klinikum Dortmund, Münsterstraße 240, 44145, Dortmund, Germany;Faculty of Health, Universität Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany;Department of Respiratory Medicine, Infectious Diseases, Sleep Medicine, St. Barbara-Klinik, Am Heessener Wald 1, 59073, Hamm, Germany;Department of Respiratory Medicine, Infectious Diseases, Intensive Care Medicine, Klinikum Dortmund, Münsterstraße 240, 44145, Dortmund, Germany;Medical Education Research Group, Medical School OWL, Bielefeld University, Universitätsstraße 25, 33615, Bielefeld, Germany;

关键词: Mycobacteria;    Prediction;    Acid-fast bacilli;    Lung infection;    Disease;    Clinical patient management;   

DOI  :  10.1186/s12890-023-02617-y

 received in 2023-03-14, accepted in 2023-08-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundKnowledge on predicting pulmonary tuberculosis (PTB) contagiosity in the hospital admission setting is limited. The objective was to assess clinical and radiological criteria to predict PTB contagiosity.MethodsRetrospective analysis of 7 clinical, 4 chest X-ray (CXR) and 5 computed tomography (CT) signs in 299 PTB patients admitted to an urban tertiary hospital from 2008 to 2016. If the acid fact bacilli stain was positive (AFB+) on admission, the case was considered high contagiosity.ResultsBest predictors for high PTB contagiosity (AFB+) were haemoptysis (OR 4.33), cough (3.00), weight loss (2.96), cavitation in CT (2.75), cavitation in CXR (2.55), tree-in-bud-sign in CT (2.12), German residency of the patient (1.89), and abnormal auscultation findings (1.83). A previous TB infection reduced the risk of contagiosity statistically (0.40). Radiographic infiltrates, miliary picture, and pleural effusion were not helpful in predicting high or low contagiosity. 34% of all patients were clinically asymptomatic (20% of the highly contagious group, 50% of the low contagious group).ConclusionHaemoptysis, cough and weight loss as well as cavitation and tree-in-bud sign in CXR/CT can be helpful to predict PTB contagiosity and to improve PTB management.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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