RT Journal Article
SR Electronic
T1 Clinicoradiological features of pulmonary tuberculosis associated with interstitial pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2649
VO 44
IS Suppl 58
A1 Kazumasa Ogawa
A1 Atsushi Miyamoto
A1 Yui Takahashi
A1 Makiko Takeyasu
A1 Sayaka Mochizuki
A1 Shigeo Hanada
A1 Hironori Uruga
A1 Hisashi Takaya
A1 Nasa Morokawa
A1 Atsuko Kurosaki
A1 Hideki Araoka
A1 Akiko Yoneyama
A1 Kazuma Kishi
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2649.abstract
AB <Introduction> Pulmonary tuberculosis (TB) occasionally develops in patients with interstitial pneumonia (IP); however, there are few reported cases of TB with IP. The aim of this study was to evaluate the clinicoradiological features of TB patients who had IP. <Methods> Of 238 patients who showed positive results for Mycobacterium tuberculosis in sputum or bronchoalveolar lavage fluid cultures at the Toranomon Hospital, Japan from April 2007 to March 2013, we included 14 TB patients with IP (12 men, 2 women; median age, 73 years). We reviewed medical charts, high-resolution computed tomography (HRCT) findings, and bacteriological results. All HRCT findings were reviewed by a thoracic radiologist and two pulmonologists.<Results> Of these 14 patients, 8 had idiopathic IP and 4 received steroid therapy. The HRCT findings of TB were classified into 3 subtypes: typical, having centrilobular nodules or cavities (4 patients, 28.6%); atypical, showing consolidation adjacent to fibrotic or emphysematous lesions without nodules (8 patients, 57.1%); and unidentifiable, characterized by no apparent TB lesions owing to diffuse parenchymal infiltrate caused by acute IP exacerbations (2 patients, 14.3%). 8 patients were treated with isoniazid, rifampicin, and ethambutol, and 6, with isoniazid, rifampicin, ethambutol, and pyrazinamide; subsequently, 13 showed a negative sputum culture. Although 4 patients could not complete the TB treatment owing to worsening of their general status, no patient died.<Conclusion> It is often difficult to diagnose TB in patients with IP because of their atypical HRCT findings ; however, appropriate TB treatment leads to a favorable outcome.