OBJECTIVE: Patients admitted to the pulmonary isolation service to rule out tuberculosis (TB) were prospectively studied to identify predictors of smear-positive TB. METHODS: History of symptoms--cough, sputum production, fever, weight loss, night sweats, hemoptysis, anorexia, and dyspnea; medical history--TB, tuberculin skin test (TST) status, TB contact; and social factors--crowding index, history of incarceration or living in a shelter, and employment status were obtained in face-to-face interviews. Chest x-rays (CXRs) were scored as typical, atypical, or negative. Serial morning sputa were collected. RESULTS: Complete data were collected on 101 patients; 44 had pulmonary TB; 33 patients were smear positive and considered infectious; 11 patients were smear negative but culture positive. There was no difference between TB and non-TB patients with respect to HIV status and social risk factors. Significant differences were found between patients who were smear positive for TB and smear negative with respect to cough, sputum, and typical CXR (79%, 76%, and 79% sensitivity, respectively). Eleven patients without TB had an atypical CXR and denied cough, sputum, and weight loss. Only one patient with TB presented this way. CONCLUSION: Even in high-risk populations, symptoms of cough, sputum, weight loss for less than 2 weeks, and the absence of a typical CXR are strong negative predictors for TB.
OBJECTIVE:Patients admitted to the pulmonary isolation service to rule out tuberculosis (TB) were prospectively studied to identify predictors of smear-positive TB. METHODS: History of symptoms--cough, sputum production, fever, weight loss, night sweats, hemoptysis, anorexia, and dyspnea; medical history--TB, tuberculin skin test (TST) status, TB contact; and social factors--crowding index, history of incarceration or living in a shelter, and employment status were obtained in face-to-face interviews. Chest x-rays (CXRs) were scored as typical, atypical, or negative. Serial morning sputa were collected. RESULTS: Complete data were collected on 101 patients; 44 had pulmonary TB; 33 patients were smear positive and considered infectious; 11 patients were smear negative but culture positive. There was no difference between TB and non-TB patients with respect to HIV status and social risk factors. Significant differences were found between patients who were smear positive for TB and smear negative with respect to cough, sputum, and typical CXR (79%, 76%, and 79% sensitivity, respectively). Eleven patients without TB had an atypical CXR and denied cough, sputum, and weight loss. Only one patient with TB presented this way. CONCLUSION: Even in high-risk populations, symptoms of cough, sputum, weight loss for less than 2 weeks, and the absence of a typical CXR are strong negative predictors for TB.
Authors: Juan P Wisnivesky; Denise Serebrisky; Carlton Moore; Henry S Sacks; Michael C Iannuzzi; Thomas McGinn Journal: J Gen Intern Med Date: 2005-10 Impact factor: 5.128
Authors: Gonzalo G Alvarez; Brian Gushulak; Khaled Abu Rumman; Ekkehardt Altpeter; Daniel Chemtob; Paul Douglas; Connie Erkens; Peter Helbling; Ingrid Hamilton; Jane Jones; Alberto Matteelli; Marie-Claire Paty; Drew L Posey; Daniel Sagebiel; Erika Slump; Anders Tegnell; Elena Rodríguez Valín; Brita Askeland Winje; Edward Ellis Journal: BMC Infect Dis Date: 2011-01-04 Impact factor: 3.090
Authors: Fernanda Carvalho de Queiroz Mello; Luiz Gustavo do Valle Bastos; Sérgio Luiz Machado Soares; Valéria M C Rezende; Marcus Barreto Conde; Richard E Chaisson; Afrânio Lineu Kritski; Antonio Ruffino-Netto; Guilherme Loureiro Werneck Journal: BMC Public Health Date: 2006-02-23 Impact factor: 3.295
Authors: René G English; Max O Bachmann; Eric D Bateman; Merrick F Zwarenstein; Lara R Fairall; Angeni Bheekie; Bosielo P Majara; Carl Lombard; Robert Scherpbier; Salah Eddine Ottomani Journal: BMC Pulm Med Date: 2006-08-25 Impact factor: 3.317