Type:
Educational Exhibit
Keywords:
Thorax, Lung, Respiratory system, Conventional radiography, CT, CT-High Resolution, Diagnostic procedure, Treatment effects, Pathology, Cavitation
Authors:
C. S. Rizzo1, A. Zanfardini2, E. P. Eyheremendy2; 1Ciudad Autonoma de Buenos Aires/AR, 2Buenos Aires/AR
DOI:
10.1594/ecr2018/C-0374
Background
Tuberculosis (TB) is a worldwide public health problem.
It is one of the top ten causes of death in the planet.
In 2016,
10.4 million people fell ill with TB,
and 1.7 million died from the disease (including 0.4 million among people with HIV).
Over 95% of TB deaths occur in low and middle-income countries.
Seven countries account for the 64% of the total,
with India leading the count,
followed by Indonesia,
China,
Philippines,
Pakistan,
Nigeria and South Africa.
The World Health Organization has recently launched the End TB Strategy as an ultimate effort to try to put an end to the spreading of the disease.
(Figure 1).
Tuberculosis manifests in active and latent forms.
Active disease can occur as primary tuberculosis,
developing shortly after infection,
or postprimary tuberculosis,
developing after a long period of latent infection.
Primary tuberculosis occurs most commonly in children and immunocompromised
patients,
who present with lymphadenopathy,
pulmonary consolidation,
and pleural effusion (Figure 2).
Postprimary tuberculosis may manifest with cavities,
consolidations,
and centrilobular nodules (Figure 3).
Miliary tuberculosis refers to hematogenously disseminated disease which presents with miliary lung nodules and may also show multiorgan involvement.
The principal means of testing for active tuberculosis is sputum analysis,
including smear,
culture,
and nucleic acid amplification testing.Chest radiographs are used to stratify for risk and to assess for asymptomatic active disease; treatment can also be monitored by chest radiographs. If tuberculosis is not initially suspected clinically but radiographic findings are concerning for active tuberculosis,
computed tomography aids in further characterization of radiographic findings,
particularly with high resolution techniques.