A STUDY OF X-RAY CHEST PATTERNS IN MULTIDRUG-RESISTANT TUBERCULOSIS (MDR-TB) BETWEEN HIV REACTIVE AND HIV NON-REACTIVE PATIENTS IN A TERTIARY HILLY MEDICAL CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 6
Abstract
BACKGROUND Globally, multidrug resistant-tuberculosis (MDR) is one of the major healthcare problems. India is not far away from that concern especially when there is an increasing association with human immunodeficiency virus (HIV). As multidrug resistant tuberculosis (MDR-TB) is determined by microbiological testing, early detection of MDR -TB by X-Ray chest is highly recommended to help in guiding diagnostic confirmation. The chest x-ray patterns in MDR-TB depends on multiple risk factors including immune status and therefore identifying the influences of HIV on chest x ray appearance may help in improving diagnosis. The objectives of the study were- 1. to describe the chest x-ray patterns in patients with MDR-TB and 2. To compare the radiological pattern in X-Ray chest amongst MDR-TB patients between HIV reactive and HIV non-reactive group. MATERIAL AND METHODS A descriptive cross-sectional study was conducted among 80 patients in the chest department of a rural tertiary care hospital in northern West Bengal during the period of 1st Dec 2016 to 30th Nov 2018. All patients were diagnosed as MDR-TB by cartridge based nucleic acid amplification test (CBNAAT) or GeneXpert. In all patients, digital x-ray chest PA and lateral view were done routinely. Side by side HIV status was assessed in all patients. Statistical analysis was performed using IBM SPSS statistics software. RESULTS Among 80 patients who were included in our study, male to female ratio was 5:3. Majority belonged to labour group 32.5%. Major radiological abnormalities found were cavitary lesions (44.12%) followed by consolidation (32.35%) in HIV non-reactive group. Whereas in HIV reactive group hilar lymphadenopathy (50%) was predominant and cavitary lesion and consolidation were less common. CONCLUSION The most common chest x-ray finding was cavitary lesion followed by consolidation especially in HIV non-reactive group. In HIV reactive group, hilar lymphadenopathy was predominant finding. Though cavitation in adult may raise the possibility of tuberculosis, it does not exclude MDR tuberculosis especially if it is multiple in number.
Authors and Affiliations
Sujit Kumar Bhattacharyya, Pratik Barma, Rajarshi Bhattacharyya
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