Tuberculosis (TB) is a communicable disease caused by Mycobacterium tuberculosis, with a global infection prevalence of about 32%(1). After inhalation, droplet nuclei are deposited within the terminal airspaces of the lung(2). In most cases the infection is successfully limited by alveolar macrophages; in a minority of cases, however, the infection progresses to active disease. The current epidemiological evidence in Italy show a low incidence in the population as a whole, but also a high concentration in some specific population groups(3, 6). Hospitalization of TB patients...

The analysis is based on a retrospective medical record of 75 (44 male, 31 female) TB patients admitted to Sant’Andrea Emergency Department (ED) from January 2008 to September 2010 and identified by Diagnosis-Related Groups (DRG) number. Men and social minorities are most susceptible people to TB infection(7). Most of these patients had multiple ED visits (29% two visits, 9% three visits). Eleven of these patients were excluded because their admission were not primarily connected to TB (trauma, nephrolithiasis or nonspecific abdominal pain).

CXR and CT taken during ED visits often showed imaging features compatible with tuberculosis although nonspecific. Imaging features upon the observed cases had the following findings: lobe/diffuse interstitial infiltrate (44%), cavitary lesion (28%), calcific lymphadenopathy (8%), pleural effusion (19%), mass or coin lesion - not cavitary (14%), calcific fibrothorax (6%), bronchial ectasia (16%), tree-in-bud (17%), ground-glass (8%), parenchymal scar (25%) and normal pleuro-parenchymal pattern (27%). Only one patient was admitted because of bone tuberculosis localization: CT taken in ED revealed an inhomogeneous mass involving a...

As already observed in literature it is frequently hard identifying tuberculosis patients during ED visits, given that patients are affected by atypical and nonspecific signs and symptoms. In our observations these critical elements were represented by cough, fever and dyspnea, according to reacutization of TB.

1.Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Consensus statement. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. WHO Global Surveillance and Monitoring Project. JAMA. 1999 Aug 18;282(7):677-86. 2.Frieden TR, Sterling TR, Munsiff SS, Watt CJ, Dye C. Tuberculosis. Lancet. 2003 Sep 13;362(9387):887-99. 3.The Stop TB Strategy - Building on and enhancing DOTS to meet the TB-related Millennium Development Goals 2006. 4.The Global Plan to Stop TB 2011-2015. 5.Global TB control report 2011. 6.Epidemiologia della tubercolosi in Italia, Istituto Superiore...

I. Casazza, M.A. Guglietta, A. Speranza, V. David, C. De Dominicis Department of Radiology Sapienza University of Rome Sant'Andrea Hospital, Rome