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Abstract
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.
Figures and Tables
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.
Table 1
Baseline Characteristics of the Study Population
Numbers in parentheses area percentage. Data are presented as mean ± SD or number of patients (%).
Note.-*p < 0.05 in comparison with community-acquired pneumonia and typical pulmonary tuberculosis.
†p < 0.05 in comparison with community-acquired pneumonia and tuberculous pneumonia.
‡p < 0.05 in comparison with tuberculous pneumonia and typical pulmonary tuberculosis.
§p < 0.05 in comparison with typical pulmonary tuberculosis.
AFB = acid-fast bacilli, BT = body temperature, CRP = C-reactive protein, DM = diabetes mellitus, LDH = lactate dehydrogenase, PSI = pneumonia severity index, WBC = white blood cells
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