Diagnosis for smear- or culture-positive pulmonary tuberculosis in 50 patients admitted to a general hospital-A retrospective analysis / 中华全科医师杂志

ABSTRACT

Objective To investigate clinical characteristics of smear- or culture-positive pulmonary tuberculosis (TB) in patients hospitalized at a general hospital to improve its diagnosis. Methods Clinical data of smear- or culture-positive pulmonary TB diagnosed in 50 patients hospitalized at Peking Union Medical College Hospital, Beijing during 2006 to 2009 were analyzed retrospectively. Results Seventeen (34%) of 50 cases of smear- or culture-positive pulmonary TB aged more than 60 years, with 30 males (32%), 16 retirees and nine farmers (18%). Their main symptoms included fever (80%), cough (94%) and sputum expectoration (92%), with elevated erythrocyte sedimentation rate (ESR) in 38 of 45 patients (84%). Chest X-ray examinations showed that lesions located mostly in the upper lobes or in both of the lungs diffusedly, with patchy infiltrations, nodular opacities and cavities. Acid-fast bacilli were demonstrated on sputum smear in 41 ( 82% ) and in specimens of six ( 12% ) cases obtained through bronchoscopy with brush or bronchoalveolar lavage fluid ( BALF), and M. Tuberculosis was cultured from sputum specimens in three (6%). Mean time interval between admission and diagnoses averaged 14 days.Conclusions Basic knowledge about prevention and control of pulmonary tuberculosis should be publicized comprehensively in general hospital keeping alert in its diagnosis with acid-fast staining for sputum smear as a routine test for patients with respiratory symptoms, and in some cases, bronchoscopy procedures ( brush or BALF) are reasonable options to improve its detection.