Multidrug-Resistant Tuberculosis Versus Drug-Sensitive Tuberculosis in Human Immunodeficiency Virus-Negative Patients: Computed Tomography Features

Objectives: To compare the computed tomography (CT) features of patients with multidrug-resistant tuberculosis with those of patients with drug-sensitive tuberculosis in a country not associated with the human immunodeficiency virus (HIV) epidemic. Methods: The CT images of 47 patients with multidrug-resistant tuberculosis were compared with those of 47 patients with drug-sensitive tuberculosis as a control group. Each multidrug-resistant tuberculosis patient was age (decade) and gender matched to a drug-sensitive tuberculosis patient. All patients were seronegative to HIV. This study evaluated the presence of centrilobular nodules, consolidation, emphysema, bronchiectasis, lung destruction, calcified granuloma, cavitation, pleural effusion, and lymphadenopathy. A statistical comparison was performed by using the Fisher exact test for univariate analysis and a multiple logistic regression method for multivariate analysis. Results: In univariate analysis, bronchiectasis, lung destruction, a calcified granuloma, and cavitation were more frequently observed in multidrug-resistant tuberculosis than in drug-sensitive tuberculosis. Multivariate analysis showed that cavity formation was the only significant difference between multidrug-resistant tuberculosis and drug-sensitive tuberculosis. In patients with cavitary tuberculosis, multiple cavities (>3 cavities) were observed only in patients with multidrug-resistant tuberculosis. Conclusions: Most patients with multidrug-resistant tuberculosis had cavity formation on CT. Although the presence of a cavity does not mean multidrug resistance, multiple cavities suggest the possibility of multidrug-resistant tuberculosis.

[1]  L. Ackerson,et al.  Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. , 1993, The New England journal of medicine.

[2]  J. Goo,et al.  CT of tuberculosis and nontuberculous mycobacterial infections. , 2002, Radiologic clinics of North America.

[3]  K. Lessnau,et al.  Radiographic findings in HIV-positive patients with sensitive and resistant tuberculosis. , 1994, Chest.

[4]  S. Greenberg,et al.  Active pulmonary tuberculosis in patients with AIDS: spectrum of radiographic findings (including a normal appearance). , 1994, Radiology.

[5]  T. Frieden,et al.  The emergence of drug-resistant tuberculosis in New York City. , 1993, The New England journal of medicine.

[6]  J. Im,et al.  Pulmonary tuberculosis: CT findings--early active disease and sequential change with antituberculous therapy. , 1993, Radiology.

[7]  E. Harrow,et al.  Epidemiology and clinical consequences of drug-resistant tuberculosis in a Guatemalan hospital. , 1998, Chest.

[8]  A. Pitchenik,et al.  Outbreaks of drug-resistant tuberculosis at AIDS centre , 1990, The Lancet.

[9]  W. Rom,et al.  Increased incidence of multidrug-resistant tuberculosis in diabetic patients on the Bellevue Chest Service, 1987 to 1997. , 2001, Chest.

[10]  Jin H. Lee,et al.  Drug-resistant tuberculosis in a tertiary referral teaching hospital of Korea , 2001, The Korean journal of internal medicine.

[11]  A. Khomenko,et al.  Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. , 1969, Bulletin of the World Health Organization.

[12]  I. Ben-Dov,et al.  Drug-resistant tuberculosis in a southern California hospital. Trends from 1969 to 1984. , 2015, The American review of respiratory disease.

[13]  L. Blumberg,et al.  A comparison of outbreak- and nonoutbreak-related multidrug-resistant tuberculosis among human immunodeficiency virus-infected patients in a South African hospital. , 1999, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  W. Lew,et al.  The seventh nationwide tuberculosis prevalence survey in Korea, 1995. , 1998, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[15]  J. Fishman,et al.  Radiographic findings and patterns in multidrug-resistant tuberculosis. , 1998, Journal of thoracic imaging.

[16]  C. Kang,et al.  Surgery increased the chance of cure in multi-drug resistant pulmonary tuberculosis. , 1999, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.