The Accuracy of Emergency Physicians' Suspicions of Active Pulmonary Tuberculosis.

Objective: To investigate factors associated with recognition and delayed isolation of pulmonary tuberculosis (PTB).

Background: Precise identification of PTB in the emergency department (ED) remains challenging.

Methods: Retrospectively reviewed PTB suspects admitted via the ED were divided into three groups based on the acid-fast bacilli culture report and whether they were isolated initially in the ED or general ward. Factors related to recognition and delayed isolation were statistically compared.

Results: Only 24.94% (100/401) of PTB suspects were truly active PTB and 33.77% (51/151) of active PTB were unrecognized in the ED. Weight loss ( = 0.022), absence of dyspnea ( = 0.021), and left upper lobe field ( = 0.024) lesions on chest radiographs were related to truly active PTB. Malignancy ( = 0.015), chronic kidney disease ( = 0.047), absence of a history of PTB ( = 0.013), and lack of right upper lung ( 0.001) and left upper lung ( = 0.020) lesions were associated with PTB being missed in the ED.

Conclusions: Weight loss, absence of dyspnea, and left upper lobe field lesions on chest radiographs were related to truly active PTB. Malignancy, chronic kidney disease, absence of a history of PTB, and absence of right and/or left upper lung lesions on chest radiography were associated with isolation delay.