J Korean Soc Radiol.  2013 Jan;68(1):21-26.

Clinical and Radiological Characteristics of Tuberculous Pneumonia: Comparison with Typical Pulmonary Tuberculosis and Community-Acquired Pneumonia

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea. hochkim@gnu.ac.kr
  • 2Department of Diagnostic Radiology, College of Medicine, Gyeongsang National University, Jinju, Korea.
  • 3Department of Preventive Medicine, College of Medicine, Gyeongsang National University, Jinju, Korea.
  • 4Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju, Korea.

Abstract

PURPOSE
To evaluate the clinical and radiological characteristics of tuberculous pneumonia (TBPn).
MATERIALS AND METHODS
We compared the clinical presentation, pneumonia severity index (PSI), and radiological findings of 51 TBPn patients with those of typical pulmonary tuberculosis (PulTB) and community-acquired pneumonia (CAP) patients.
RESULTS
The mean age of patients with TBPn was higher than that of patients with CAP or PulTB (66.6 +/- 15.8 vs. 53.1 +/- 17.1, 54.9 +/- 15.7) (p < 0.05). Diabetes mellitus was more common in patients with TB than in those with CAP (24.1% vs. 8.2%) (p < 0.05). The PSI scores for TBPn and CAP were similar (79.5 +/- 31.1 vs. 71.8 +/- 28.3, respectively) and were higher than that for PulTB (64 +/- 26.8) (p < 0.05). The ratio of lower lobe involvement was higher in TBPn and CAP than in PulTB (49% and 75.5% vs. 22.4%, respectively). Cavity formation and centrilobular nodules were more common in TBPn than in CAP (13.7% vs. 6.1% and 74.5% vs. 22.4%, respectively) (p < 0.05).
CONCLUSION
Although TBPn shows a similar clinical presentation to CAP, it is more common in elderly patients and more commonly involves lower lobe involvement with cavity formation and centrilobular nodules. Therefore, in cases in which there may be diagnostic uncertainty, appropriate diagnostic procedures following these findings are required to differentiate these diseases.


MeSH Terms

Aged
Diabetes Mellitus
Humans
Pneumonia
Tuberculosis, Pulmonary
Uncertainty

Figure

  • Fig. 1 A case of tuberculous pneumonia: a 65-year-old man presenting with a 3-week history of cough and malaise. Chest radiography and CT reveal consolidation of the left lower lobe with underlying emphysema.

  • Fig. 2 A case of typical pulmonary tuberculosis: a 58-year-old man reporting expectoration of blood-tinged sputum for several days. Chest radiography and CT reveal a cavity with surrounding centrilobular nodule in the right upper lobe.

  • Fig. 3 A case of community-acquired pneumonia: a 69-year-old man reporting sputum expectoration and febrile illness for several days. Chest radiography and CT reveal consolidation with air bronchogram in the lingular division of the left upper lobe.


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