Purpose: The purpose of this study was to evaluate the capabilities of chest computed tomography (CT) in distinguishing between active and latent tuberculosis in patients positive for interferon-gamma release assay (IGRA) testing, and to compare the performance of CT with that of quantitative IGRA testing in a low incidence setting.
Materials And Methods: Patients with latent or active tuberculosis define by an IGRA positive test were retrospectively recruited. Sensitivity, specificity and accuracy were determined for CT variables and quantitative IGRA results. Final diagnosis of active tuberculosis was based on clinical data and microbiological culture. Univariable and multivariable analyses were performed using logistic regression model to identify CT variables associated with the diagnosis of active tuberculosis.
Results: A total of 92 patients with positive IGRA results who underwent CT examination were included. There were 54 men and 38 women with a mean age of 53.5±18 (SD) years (range: 40-68 years). Of them, 22 patients (24%) had positive Mycobacterium tuberculosis culture and 70 (76%) had latent tuberculosis. Among CT variables, consolidation had the greatest sensitivity (77%; 95%CI: 60-95%) and "tree-in-bud" the greatest specificity (97%; 95% CI: 93-100%) for the diagnosis of active tuberculosis. At univariable analysis "tree-in-bud", splenic calcification and non-calcified lung nodules were the significant variables independently associated with active tuberculosis. At multivariable analysis, the adjusted odds ratio of "tree-in-bud" was 42.91 (95% CI: 5.62-327.42). Using an optimal threshold of 51 spots, quantitative IGRA yielded 64% sensitivity (95% CI: 44-84%) and 61% specificity (95% CI: 50-73%) for the diagnosis of active tuberculosis.
Conclusions: In a low incidence setting, chest CT, especially when "tree-in-bud" pattern is present, is superior to quantitative IGRA testing to identify patients with active tuberculosis among those with positive IGRA testing.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.diii.2021.05.011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review.
F1000Res
January 2025
Faculty of Medicine and Health Sciences, Division of Epidemiology and Biostatistics, Stellenbosch University Centre for Evidence-Based Health Care, Cape Town, South Africa.
Background: Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission.
Objectives: We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation.
Introduction Tuberculosis (TB) is an infectious disease caused by . Various studies have established an association between diabetes mellitus (DM) and pulmonary TB. This study describes the prevalence of DM and its predictors in smear-positive TB patients.
View Article and Find Full Text PDFBackground: Among occupational hazards in healthcare settings, latent tuberculosis infection (LTBI) ranks as a major concern, particularly threatening healthcare workers (HCWs) in nations grappling with intermediate to high tuberculosis (TB) rates. Our study was conducted in Morocco, a country characterized by widespread Bacillus Calmette-Guérin (BCG) vaccination and a moderate TB burden of 93 cases per 100,000 inhabitants in 2022. We examined both the prevalence of LTBI among Moroccan HCWs and its various risk factors.
View Article and Find Full Text PDFGenomic modifications for enhanced antibiotic production in rifamycin derivative-producing S699 strains: focusing on and genes.
Front Antibiot
June 2024
Institute of Pharmaceutical Biology and Biotechnology, Albert-Ludwigs-Universität, Freiburg, Germany.
Rifamycin and its derivatives are natural products that belong to the class of antibiotic-active polyketides and have significant therapeutic relevance within the therapy scheme of tuberculosis, a worldwide infectious disease caused by . Improving the oral bioavailability of rifamycin B was achieved through semisynthetic modifications, leading to clinically effective derivatives such as rifampicin. Genetic manipulation of the rifamycin polyketide synthase gene cluster responsible for the production of rifamycin B in the strain S699 represents a promising tool to generate new rifamycins.
View Article and Find Full Text PDFClinical and imaging features of co-existent pulmonary tuberculosis and lung cancer: a population-based matching study in China.
BMC Cancer
January 2025
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, P.R. China.
Background: Co-existent pulmonary tuberculosis and lung cancer (PTB-LC) represent a unique disease entity often characterized by missed or delayed diagnosis. This study aimed to investigate the clinical and radiological features of patients diagnosed with PTB-LC.
Methods: Patients diagnosed with active PTB-LC (APTB-LC), inactive PTB-LC (IAPTB), and LC alone without PTB between 2010 and 2022 at our institute were retrospectively collected and 1:1:1 matched based on gender, age, and time of admission.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!