Profile and outcome of unilateral tuberculous lung destruction in Ilorin, Nigeria.

Background: Unilateral tuberculous lung destruction is a serious chronically disabling and often fatal complication of pulmonary tuberculosis. A few previous studies have dealt with some aspects of this entity among Nigerians with pulmonary tuberculosis but these studies may not truly reflect its current trends.

Objective: To describe the presenting profiles and outcome of unilateral tuberculous lung destruction among patients with pulmonary tuberculosis.

Methods: The study was a chart review of the medical records of adult patients with pulmonary tuberculosis complicated by unilateral lung destruction seen between January 1999- December 2008. Data extracted included demographic, and outcome of treatment. The clinical features, sputum results and illustrative cases are presented.

Results: Unilateral lung destruction complicated 74(1.3%) of 5,926 pulmonary tuberculosis cases seen over the review period. Most cases occurred in males [45(60.8%)] and they were predominantly [51(68.9%)] below 40 years of age. Most of them [52(70.2%)] presented after six months of symptoms. Forty-seven (63.5%) of them had had previous exposure to antituberculosis drugs. The left lung was affected in 49 (66.2%) patients. Only 25 (33.8%) of them were cured while the adjusted mortality rate was 25.5%. Male gender, presence of dyspnoea on mild exertion and right ventricular failure were significantly associated with increased mortality.

Conclusion: Unilateral tuberculous lung destruction has unacceptably high mortality rate which can be prevented by patient presenting early to the hospital, prompt diagnosis and strict adherence to the standard treatment.