RADIOLOGICAL PRESENTATION OF POST PRIMARY TUBERCULOSIS IN ADULT SPUTUM SMEAR POSITIVE PATIENTS

Abstract

Background: Pulmonary Tuberculosis (TB) is traditionally classified into primary & post primary
tuberculosis; both have distinct characteristics on radiology. A detailed knowledge of different radiological
patterns is helpful in diagnosis of TB. Objective: To determine the frequency of various radiological
presentation of post primary tuberculosis in adult sputum smear positive patients. Methodology: This cross
sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital,
Rahim Yar Khan on adult sputum smear positive pulmonary TB patients. A total of 250 new cases of
pulmonary TB with no previous history of Anti-Tuberculosis treatment were included in this study. Socio
demographic data and findings of X – ray Chest from each sputum smear positive patient were collected and
recorded on a predesigned performa. The data was entered and analyzed by using SPSS version 17. Result:
Out of 250 patients, 146 were male and 104 were female with mean age of 35.76 ± 16.25 years. Left lung was
most affected in 40.4% cases, right lung in 35.6%, while 24% has bilateral involvement. Duration of illness
prior to diagnosis was 3 ± 1.66 months. Among the radiological presentation, cavitation was seen in 49.2%
cases, alveolar consolidation in 42.4%, nodular pattern in 3.2%, reticulonodular pattern in 3.2% and
reticular pattern in 2% cases. There was significant association of alveolar consolidation with male gender
(0.03) while reticulonodular pattern was significantly seen in female gender (0.007). Majority of the
patients were young; 42.8% were below the age of 30 years and 82% patients were below the age of 50 years
and there was a delay of > 03 months in the diagnosis. Conclusion: According to this study, cavitations and
alveolar consolidation were the commonest radiological presentations of post primary TB. Majority of
patients were young and there was a considerable delay in diagnosis.