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Pulmonary tuberculosis presenting as community‐acquired pneumonia
Author(s) -
LIAM ChongKin,
PANG YongKek,
POOSPARAJAH Shyamala
Publication year - 2006
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2006.00947.x
Subject(s) - medicine , tuberculosis , community acquired pneumonia , chest radiograph , odds ratio , etiology , pneumonia , mycobacterium tuberculosis , confidence interval , surgery , gastroenterology , lung , pathology
Objective and background: The aims of this study were to investigate the frequency of Mycobacterium tuberculosis as a cause of community‐acquired pneumonia (CAP) requiring hospitalization in Malaysia, and to define the clinical features of pulmonary tuberculosis (PTB) that distinguish it from non‐TB CAP. Methods: A prospective study was performed on consecutive non‐immunocompromised patients aged 12 years and older, who were hospitalized for CAP. Results: Of a total of 346 patients hospitalized for CAP, the aetiological agent was identified in 163 patients (47.1%). M. tuberculosis was isolated in 17 patients (4.9%). Multivariate analysis revealed that the following features were significantly associated with culture‐positive PTB: duration of symptoms of more than 2 weeks before hospital admission (odds ratio (OR) 25.10; 95% confidence interval (CI) 4.63–136.05; P < 0.001), history of night sweats (OR 5.43; 95% CI 1.10–26.79; P = 0.038), chest radiograph showing upper lobe involvement (OR 8.23; 95% CI 1.59–42.53; P = 0.012) or cavitary infiltrates (OR 19.41; 95% CI 2.94–128.19; P = 0.002), total white blood cell count on admission of 12 × 10 9 /L or less (OR 6.28; 95% CI 1.21–32.52; P = 0.029) and lymphopenia (OR 4.73; 95% CI 1.08–20.85; P = 0.040). Conclusion: Mycobacterium tuberculosis was not an uncommon cause of CAP requiring hospitalization in Malaysia. A longer duration of symptoms, history of night sweats, upper lobe involvement, cavitary infiltrates, lower total white blood cell count and lymphopenia were predictive of PTB.