Source: Annual Congress 2008 - Diagnosis of tuberculosis: problems and perspectives
Disease area: Respiratory infections

Abstract

Pulmonary tuberculosis (Ptb) remains frequent in our country despite the prevalence decrease (23 / 100.000).Radiologic aspects are usually typical dominated by nodules, cavitations and infiltrations. Lesions with air fluid level (AFL) are rarely described in Ptb in literature.
We report 3 cases of Ptb with AFL on chest X ray. Mean age was 5O years. All patients were smokers. One patient was diabetic. No patient had HIV infection. Cough and fever were present in all cases. The AFL was located in the left upper lobe in all cases. Ptb was confirmed by positive smear bacilli in two cases. In the third case, lung abscess and other lung infections were first evoked and antibiotic treatment was administrated based on β lactamin and quinolone with initial good response. Tuberculosis was confirmed by bronchial fluid culture two months later. Response to treatment was favorable, under a 6 months anti tuberculosis regimen, with parenchymal fibrous sequellae in all cases however.
This report illustrates the diagnosis difficulties of Ptb with AFL radiological aspects, and the importance of evoking Ptb even in case of a favorable initial response to non specific antibiotherapy. The latter should avoid those antibiotics with anti tuberculosis activity like quinolones in a first intention to minimize resistance risk.

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Citations should be made in the following way:
N. Chaouch, M. Zarrouk, A. Messaâdi, S. Cheikh Rouhou, H. Racil, A. Chabbou (Ariana, Tunisia). A misdiagnosis radiological aspect of pulmonary tuberculosis. Eur Respir J 2008; 32: Suppl. 52, 2381

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