Kunihiko Ito1. 1. Department of Research, Research Institute of Tuberculosis, JATA, 3-1-24, Matsuyama, Kiyose-shi, Tokyo 204-8533 Japan. ito@jata.or.jp
Abstract
PURPOSE: To investigate the usefulness of chest X-ray investigation for early diagnosis of recurrent pulmonary tuberculosis. OBJECT: Patients who start re-treatment at Fukujuji Hospital from 1993 to 2003 due to the recurrence of lung tuberculosis after the completion of standard chemotherapy. METHOD: Chart review. RESULT: Deterioration of chest X-ray was not observed in 19.5% (8/41) of recurrent pulmonary tuberculosis, and in 4 cases even improvement of chest X-ray finding was observed. Sensitivity of chest X-ray in all recurrent cases was around 80 %, and this figure did not increase in smear positive recurrent cases. Sensitivity of chest X-ray for symptomatic recurrent cases was 92.3%, and that for non-symptomatic recurrent cases 60.0%, which is significantly lower than that for symptomatic cases. CONCLUSION: Sensitivity of chest X-ray for early diagnosis of recurrent pulmonary tuberculosis is not very high, and bacteriological examinations are more important irrespective of chest X-ray finding. Especially in non-symptomatic recurrent cases, usefulness of chest X-ray is considerably limited. Method and necessity of regular follow-up in non-symptomatic persons after successful tuberculosis chemotherapy should be re-considered.
PURPOSE: To investigate the usefulness of chest X-ray investigation for early diagnosis of recurrent pulmonary tuberculosis. OBJECT: Patients who start re-treatment at Fukujuji Hospital from 1993 to 2003 due to the recurrence of lung tuberculosis after the completion of standard chemotherapy. METHOD: Chart review. RESULT: Deterioration of chest X-ray was not observed in 19.5% (8/41) of recurrent pulmonary tuberculosis, and in 4 cases even improvement of chest X-ray finding was observed. Sensitivity of chest X-ray in all recurrent cases was around 80 %, and this figure did not increase in smear positive recurrent cases. Sensitivity of chest X-ray for symptomatic recurrent cases was 92.3%, and that for non-symptomatic recurrent cases 60.0%, which is significantly lower than that for symptomatic cases. CONCLUSION: Sensitivity of chest X-ray for early diagnosis of recurrent pulmonary tuberculosis is not very high, and bacteriological examinations are more important irrespective of chest X-ray finding. Especially in non-symptomatic recurrent cases, usefulness of chest X-ray is considerably limited. Method and necessity of regular follow-up in non-symptomatic persons after successful tuberculosis chemotherapy should be re-considered.