Gambaran Radiografi Tuberkulosis Paru Multidrug-Resistant: Studi Retrospektif di Rumah Sakit Umum Dr. Soetomo Surabaya
[Chest Imaging in Multidrug-Resistant Pulmonary Tuberculosis: Retrospectif Study in Dr. Soetomo General Hospital Surabaya]
Downloads
Background: Multidrug-resistant pulmonary tuberculosis (MDR-TB) is a major health problem worldwide. Prompt diagnosis is necessary for insuring appropriate therapy to lower morbidity and mortality, as well as to prevent disease transmission. Determination of drug-resistance patterns through microbiological examination is sometimes challenging, especially when the sputum acid-fast bacilli smear is negative. Therefore, it is worthwhile to investigate whether there may be radiographic patterns suggesting MDR-TB infection. The objective of this study was to evaluate the radiographic features of MDR-TB. Methods: From September 2015 to March 2018, 167 patients with microbiologically proven MDR-TB were enrolled in the study. All radiographs were obtained before the patients received MDR-TB chemotherapy regimen. Posterior-anterior chest radiography was performed using digital radiography system (Hitachi Radnext50 500mAs) and retrospectively reviewed as digital raw data. Results: Based on severity category, 60% had severe lesion, 31% had moderate lesion, and only 9% had mild lesion. The most frequently observed findings were ground glass opacity or consolidation, noted in 96% patients, with bilateral lung involvement in 81% patients; fibrosis (95%), cavity (78%; 87% of which were multiple), interstitial opacities (53%), pleural thickening and mediastinal shift (59%). Other radiological findings were calcification (16%), emphysema (13%), lung destruction (12%), atelectasis (10%), nodule (8%), bullae (8%), bronchiectasis (5%), miliary pattern (1%), pleural effusion (25%), pneumothorax (1%), and hilar lymphadenopathy (14%) which predominantly unilateral. Conclusion: The presence of severe pulmonary lesion, ground glass opacity or consolidation with bilateral lung involvement, fibrosis, multiple cavities, interstitial opacities, pleural thickening, and mediastinal shift are the main features of MDR-TB.
Hicks A, Muthukumarasamy S, Maxwell D, Howlett D. Chronic Inactive Pulmonary Tuberculosis and Treatment Sequelae : Chest Radiographic Features. Int J Tuberc Lung Dis. 2014;18(May 2013):128–33.
WHO. Global Tuberculosis Report 2015, 20th Edition. 2015;1–30.
M Subuh, Priohutomo S. Pedoman Nasional Pengendalian Tuberkulosis. Jakarta: Kementrian Kesehatan RI; 2014. 6-140 P.
Hyo-Cheol Kim, Jin Mo Goo, Hyun Ju Lee, Seong Ho Park, Chang Min Park, Tae Jung Kim J-GI. Multidrug-Resistant Tuberculosis versus Drug-Sensitive Tuberculosis in Human Immunodeficiency. J Comput Assist Tomogr. 2004;28(3):366–71.
Kim W, Lee KS, Kim HS, Koh W. CT and Microbiologic Follow-Up in Primary Multidrug-Resistant Pulmonary Tuberculosis. Acta Radiol. 2015;0(0):1–8.
Kim SH, Min JH, Lee JY. Radiological Findings of Primary Multidrug-Resistant Pulmonary Tuberculosis in HIV-Seronegative Patients. Hong Kong J Radiol. 2014;17:4–8.
Cegielski JP, Arab L, Cornoni-Huntley J. Nutritional Risk Factors for Tuberculosis among Adults in the United States, 1971–1992. Am J Epidemiol. 2018;176(5):409–22.
Michael N. Bates, Asheena Khalakdina, Madhukar Pai, Lisa Chang, Fernanda Lessa KRS. Risk of Tuberculosis from Exposure to Tobacco Smoke. Arch Intern Med. 2015;167:335–42.
Medea Gegia A, Matthew J Magee B, Russell R Kempker C, Iagor Kalandadze D, Tsira Chakhaia A JEG E & HMB. Tobacco Smoking and Tuberculosis Treatment Outcomes_ A Prospective Cohort Study in Georgia. Bull World Health Organ. 2015;93:390–9.
Aziza Ghanie Icksan, Martin Raja Sonang Napitupulu, Mohamad Arifin Nawas FN. Chest X-Ray Findings Comparison between Multi-Drug-Resistant Tuberculosis and Drug-Sensitive Tuberculosis Icksan AG, Sonang Napitupulu MR, Nawas MA, Nurwidya F - J Nat Sc Biol Med. Jakarta: CV Sagung Seto; 2008. 2-106 P.
Yeom JA, Jeong YJ, Jeon D, Kim ížK, Kim CW, Park HK, et al. Imaging Findings of Primary Multidrug-Resistant Tuberculosis : A Comparison with Findings of Drug-Sensitive Tuberculosis. J Comput Assist Tomogr. 2009;33(6):956–60.
Chung MJ, Lee KS. Drug-Sensitive Tuberculosis, Multidrug-Resistant Tuberculosis, and Nontuberculous Mycobacterial Pulmonary Disease in Nonaids Adults : Comparisons of Thin-Section CT Findings. Eur Radiol. 2006;16:1934–41.
Song Y, Park CM. Drug-Resistant Tuberculosis Including Multidrug Resistant and Extensively Drug Resistant Tuberculosis : Their Clinical Significance and Features , Imaging Characteristics. Eur Soc Radiol. 2011;C-0855:1–22.
Navarro Ballester A. Computed Tomography Features of Multi- Drug-Resistant Pulmonary Tuberculosis in Non-HIV-Infected Patients. Smgroup, Pamplona. 2016;1–12.
Jihoon Cha, Ho Yun Lee, Kyung Soo Lee, Won-Jung Koh, O Jung Kwon, Chin A Yi, Tae Sung Kim MJC. Radiological Findings of Extensively Drug-Resistant Pulmonary Tuberculosis in Non-AIDS Adults : Comparisons with Findings of Multidrug-Resistant and. Korean J Radiol. 2009;10(June):207–16.
Lee ES, Park CM, Goo JM, Yim J, Kim H, Lee ížHJ, et al. Computed Tomography Features of Extensively Drug-Resistant Pulmonary Tuberculosis in Non HIV-Infected Patients. J Comput Assist Tomogr. 2010;34(4):559–63.
Palmero D, Ritacco V, Ambroggi M, Natiello M, Barrera L, Capone L, et al. Multidrug-Resistant Tuberculosis in HIV-Negative Patients, Buenos Aires, Argentina. Emerg Infect Dis. 2003;9(8):965–9.
Zahirifard S. The Radiological Spectrum of. 1999;1999–2004.
Dheda K, Booth H. Lung Remodeling in Pulmonary Tuberculosis. J Infect Dis. 2005;192(7):1201–1210.
Copyright (c) 2018 Stephanie Christina Sulaiman, Lulus Handayani, Mohammad Yamin Sunaryo Suwandi, Soedarsono Soedarsono
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions.
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.