Radiological Follow-up of Pulmonary Tuberculosis

Tariq A Gojwari

doi:10.33883/jms.v19i1.273

Abstract

Tuberculosis is a global health problem and is the second leading infectious cause of death, after human immunodeficiency virus (HIV). In 2014, there were an estimated 9.6 million incident cases of TB (range, 9.1 million–10.0 million) globally, equivalent to 133 cases per 100 000 population 1 . Most of the estimated number of cases in 2014 occurred in Asia (58%) and the African Region (28%). The six countries that stood out as having the largest number of incident cases in 2014 were India, Indonesia, China, Nigeria, Pakistan and South Africa. There were an estimated 1.5 million TB deaths in 2014 , 1.1 million among HIV-negative people and 390 000 among HIV- positive people 1 . These numbers show the importance of tuberculosis as a community health problem especially in our part of the world despite the leaps and bounds with which medicine has progressed our the past century. Furthermore, this issue itself has two articles related to tuberculosis by Koul et al and Rangrez et al highlighting the fact that there still is a lot that we have to learn about TB. JMS 2016; 19(1):2-4

Highlights

Tuberculosis is a global health problem and is the second leading infectious cause of death, after human immunodeficiency virus (HIV)
Owing to limited sensitivity of sputum smears and the time taken for culture results to be available, radiology has an important role in the diagnosis of Pulmonary Tuberculosis (PTB)
It is pertinent to identify whether the disease is active or inactive. This is important to make critical treatment related decisions, such as, whether to prolong the intensive phase or continuation phase of ATT, whether to add other second line drugs considering the possibility of MDR and XDR TB, whether to stop treatment or to consider other diagnoses

Summary

Introduction

Tuberculosis is a global health problem and is the second leading infectious cause of death, after human immunodeficiency virus (HIV). Owing to limited sensitivity of sputum smears and the time taken for culture results to be available, radiology has an important role in the diagnosis of PTB .2,3 While Chest X-ray (CXR) and Computed Tomography(CT) are both corner stones in the radiological evaluation of PTB, CT is the more sensitive and specific modality of the two, but delivers a much higher radiation dose to the patient .4,5 It is important to obtain relevant information without imposing an unnecessary radiation exposure or financial burden. After treatment for PTB is initiated previous radiological findings may change or new findings may appear depending on the patients response.

Results

Conclusion