Abstract
Aims: Normal chest x-rays (CXRs) have been found in those with culture-positive pulmonary tuberculosis, even without HIV co-infection. We wished to know how frequently this occurs, how frequently such patients are smear-positive and therefore infectious, whether contacts of these patients had evidence of tuberculosis and whether the site of disease can be identified by CT scan.
Methods: Records from the tuberculosis clinic at the Homerton Hospital, London, were reviewed for the period 2003-January 2012. All cases of culture positive pulmonary tuberculosis were reviewed and for those with a reported normal CXR the case notes were reviewed.
Results: 13 of 364 cases of culture positive pulmonary tuberculosis had a normal CXR. This included 6 of 34 (18%) with HIV co-infection. The frequency of a normal CXR was 3 of 233 (1.3%) with a negative HIV test. Data from one case without an HIV test and another with ++ smear but no culture are included:
Conclusions: Although 3 sputum samples were usually sent, often only one proved culture-positive. CT scans may not reveal active disease. Two with a positive smear had contacts who had forms of TB suggesting recent infection.
- © 2012 ERS