Factors Associated With Sputum Culture-Negative vs Culture-Positive Diagnosis of Pulmonary Tuberculosis

Key Points Question What proportion of patients with pulmonary tuberculosis have negative sputum culture results, and how do they present differently from patients with culture-positive pulmonary tuberculosis? Findings In our cross-sectional study of 796 patients without HIV infection who were diagnosed with pulmonary tuberculosis, sputum culture-negative pulmonary tuberculosis represented 15% of all adult patients with pulmonary tuberculosis in New York, New York. These patients had a significantly lower proportion of cough, weight loss, any symptom in general, and cavitation on imaging compared with patients with sputum culture-positive disease. Meaning Through awareness of these findings, the detection and treatment of this likely early disease could potentially be improved and the development of transmissible tuberculosis reduced.