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. 2023 Sep 6;23(1):328.
doi: 10.1186/s12890-023-02617-y.

Clinical and imaging factors that can predict contagiousness of pulmonary tuberculosis

Markus Unnewehr  1   2   3 , Florian Meyer-Oschatz  4   5 , Hendrik Friederichs  6 , Wolfram Windisch  7   8 , Bernhard Schaaf  7   9
Affiliations

Clinical and imaging factors that can predict contagiousness of pulmonary tuberculosis

Markus Unnewehr et al. BMC Pulm Med. .

Abstract

Background: Knowledge on predicting pulmonary tuberculosis (PTB) contagiosity in the hospital admission setting is limited. The objective was to assess clinical and radiological criteria to predict PTB contagiosity.

Methods: Retrospective analysis of 7 clinical, 4 chest X-ray (CXR) and 5 computed tomography (CT) signs in 299 PTB patients admitted to an urban tertiary hospital from 2008 to 2016. If the acid fact bacilli stain was positive (AFB+) on admission, the case was considered high contagiosity.

Results: Best predictors for high PTB contagiosity (AFB+) were haemoptysis (OR 4.33), cough (3.00), weight loss (2.96), cavitation in CT (2.75), cavitation in CXR (2.55), tree-in-bud-sign in CT (2.12), German residency of the patient (1.89), and abnormal auscultation findings (1.83). A previous TB infection reduced the risk of contagiosity statistically (0.40). Radiographic infiltrates, miliary picture, and pleural effusion were not helpful in predicting high or low contagiosity. 34% of all patients were clinically asymptomatic (20% of the highly contagious group, 50% of the low contagious group).

Conclusion: Haemoptysis, cough and weight loss as well as cavitation and tree-in-bud sign in CXR/CT can be helpful to predict PTB contagiosity and to improve PTB management.

Keywords: Acid-fast bacilli; Clinical patient management; Disease; Lung infection; Mycobacteria; Prediction.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the inclusion and exclusion criteria of the patients
See this image and copyright information in PMC

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