Changes in chest X-ray findings in 1-and 2-month group after treatment initiation for suspected pulmonary tuberculosis

被引:8
作者
Lee, Jang Ho [1 ]
Kim, Ock-Hwa [1 ]
Kim, Yeon Joo [1 ]
Shim, Tae Sun [1 ]
Jo, Kyung-Wook [1 ]
机构
[1] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Div Pulm & Crit Care Med,Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea
关键词
Antitubercular agents; Follow-up studies; Pulmonary tuberculosis; X-rays; DIAGNOSIS; THERAPY; MTB/RIF;
D O I
10.3904/kjim.2019.036
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: Although re-evaluation of radiographic follow-up after 2 to 3 months of therapy is recommended for patients administered anti-tuberculosis medication owing to suspected pulmonary tuberculosis, reported findings are limited. Therefore, this study aimed to investigate changes in 1- and 2-month chest X-ray (CXR) findings after the treatment initiation and compared them according to the final diagnosis of tuberculosis or non-tuberculosis. Methods: Patients who started anti-tuberculosis medication for suspected pulmonary tuberculosis were selected at a tertiary referral hospital in South Korea between January 2012 and December 2015. Changes in the 1- and 2-month CXR findings were classified as improved, unchanged, and aggravated. Results: Among the 120 patients enrolled in the i-month CXR group, 76 (63.3%) had the final diagnosis of tuberculosis. Comparison between the 1-month CXR changes and diagnosis showed that the final diagnosis was tuberculosis in 81.8% (45/55), 50.0% (26/52), and 38.5% (5/13) of patients whose 1-month CXR was improved, unchanged, and aggravated, respectively. In the 2-month CXR group, 167 patients were enrolled, and 139 (83.2%) of them were diagnosed with tuberculosis. Tuberculosis was the final diagnosis in 92.6% (100/108), 70.0% (35/50), and 44.4% (4/9) patients with improved, unchanged, and aggravated z-month CXR findings, respectively. In patients with the final diagnosis of non-tuberculosis, nontuberculous mycobacteria and malignancy were the most common causes of improved and aggravated 1- and 2-month CXR findings, respectively. Conclusions: Two-month CXR findings were of limited value for deciding on whether to continue anti-tuberculosis treatment. One-month CXR findings could help determine the need for further work-up.
引用
收藏
页码:1145 / 1153
页数:9
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