Clinical and radiographic manifestations of sputum culture-negative pulmonary tuberculosis

Minh Vu H Nguyen, Elizabeth R. Jenny-Avital, Susanne Burger, Eric M. Leibert, Jacqueline M. Achkar

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Intervention at the earliest possible stage of pulmonary tuberculosis (PTB) reduces morbidity for the individual and transmission for the community. We characterize the clinical and radiographic manifestations of sputum culture-negative (Cx-) PTB in order to facilitate awareness of this under recognized and likely early disease state. In this cross-sectional sub-study, we reviewed the medical records of HIV-uninfected PTB patients enrolled from 2006-2014 within the context of a TB biomarker study in New York City. Cx- PTB was defined as clinical and/or radiographic presentation consistent with PTB, three initial mycobacterial sputum cultures negative, and no evidence of other respiratory disease. Diagnosis was confirmed by clinical and radiographic improvement on antituberculous treatment and/ or culture, nucleic acid, or histological confirmation from a specimen other than the initial three sputa. Cx+ PTB was defined as above but with M. tuberculosis growth in at least one of the first three sputum cultures. Demographics, symptoms, and radiographic findings on initial presentation were compared between the two groups. Of 99 subjects diagnosed with PTB, 21 met the criteria of Cx- PTB. Cx- compared to Cx+ subjects presented with a significantly lower frequency of cough (70% vs. 91%, P = 0.02), sputum production (30% vs. 64%, P <0.01), weight loss (25% vs. 54%, P = 0.02), and frequency of cavitation on chest CT (12% vs. 68%, P <0.01). Our findings should raise awareness that neither a positive culture nor the hallmark symptoms are invariably associated with early TB disease.

Original languageEnglish (US)
Article numbere0140003
JournalPLoS One
Volume10
Issue number10
DOIs
StatePublished - Oct 8 2015

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Sputum
Pulmonary Tuberculosis
tuberculosis
lungs
Pulmonary diseases
Biomarkers
Cavitation
Nucleic Acids
signs and symptoms (animals and humans)
cough
Cough
chest
Medical Records
Weight Loss
respiratory tract diseases
nucleic acids
Tuberculosis
Thorax
morbidity
Cross-Sectional Studies

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Clinical and radiographic manifestations of sputum culture-negative pulmonary tuberculosis. / Nguyen, Minh Vu H; Jenny-Avital, Elizabeth R.; Burger, Susanne; Leibert, Eric M.; Achkar, Jacqueline M.

In: PLoS One, Vol. 10, No. 10, e0140003, 08.10.2015.

Research output: Contribution to journalArticle

Nguyen, Minh Vu H ; Jenny-Avital, Elizabeth R. ; Burger, Susanne ; Leibert, Eric M. ; Achkar, Jacqueline M. / Clinical and radiographic manifestations of sputum culture-negative pulmonary tuberculosis. In: PLoS One. 2015 ; Vol. 10, No. 10.
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