Logo-aim
Arch Iran Med. 2012;15(1): 0.
PMID: 22208439
Scopus ID: 84855722898
  Abstract View: 2505
  PDF Download: 1228

Original Article

Clinical and Laboratory Diagnosis of the Patients with Sputum Smear-negative Pulmonary Tuberculosis

Roya Alavi-Naini*, Luis E. Cuevas, S. Bertel Squire, Mehdi Mohammadi, Ali-Asghar Davoudikia
*Corresponding Author: Email:

Abstract

BACKGROUND: The objective of this study is to describe the proportion of patients with chronic cough and negative smear microscopy appropriately diagnosed as tuberculosis (TB) and to identify clinical features that could be used in developing a diagnostic scoring system for smear-negative patients.
METHODS: Records of patients with chronic cough and ≥ 3 negative sputum smears for acid fast bacilli who attended a reference University hospital in south-eastern Iran and screened by culture were retrospectively reviewed. We compared confirmed smear-negative pulmonary TB (PTB; culture-positive) and unconfirmed smear-negative patients (culture-negative) to describe the appropriateness of treatment and their characteristics. Features independently predictive of smear-negative PTB (SNPTB) were entered into a logistic regression to create a diagnostic rule.
RESULTS: This study enrolled 350 patients, of which 52 (14.8%) were culture-positive and 298 (85.2%) culture-negative. Of these, 38 out of 52 (sensitivity 73%) confirmed SNPTB were diagnosed as TB and 283 out of 298 (specificity 95%) unconfirmed sputum-negative patients were diagnosed as non-PTB. Variables associated with confirmed SNPTB were the presence of night sweats, family history of TB, typical chest radiography, erythrocyte sedimentation rate > 45 mm and white blood cell count < 11000/mL. The score constructed with these variables had a sensitivity of 94% and specificity of 74% with an area under the curve of 0.90.
CONCLUSION: The clinical differences between SNPTB and control patients could be used to develop a clinical scoring system to identify patients with SNPTB.

First Name
 
Last Name
 
Email Address
 
Comments
 
Security code


Abstract View: 2506

Your browser does not support the canvas element.


PDF Download: 1228

Your browser does not support the canvas element.

ePublished: 01 Jan 2012
EndNote EndNote

(Enw Format - Win & Mac)

BibTeX BibTeX

(Bib Format - Win & Mac)

Bookends Bookends

(Ris Format - Mac only)

EasyBib EasyBib

(Ris Format - Win & Mac)

Medlars Medlars

(Txt Format - Win & Mac)

Mendeley Web Mendeley Web
Mendeley Mendeley

(Ris Format - Win & Mac)

Papers Papers

(Ris Format - Win & Mac)

ProCite ProCite

(Ris Format - Win & Mac)

Reference Manager Reference Manager

(Ris Format - Win only)

Refworks Refworks

(Refworks Format - Win & Mac)

Zotero Zotero

(Ris Format - Firefox Plugin)