Chest
Clinical Investigations: InfectionPulmonary Tuberculosis Treated With Directly Observed Therapy: Serial Changes in Lung Structure and Function
Section snippets
MATERIALS AND METHODS
Over a 17-month period, all adults (18 years or older) diagnosed as having new active (never previously reported) pulmonary TB in the province of Manitoba (population 1,091,942 in 1991), Canada, were evaluated prospectively for entry into a study of lung structure and function. Patients were required to meet all of the following entrance criteria: (1) no known preexisting lung disease; (2) no illness and no therapy known to compromise immune function; (3) willing and able to receive supervised
RESULTS
During the 17-month study period, there were 84 adults diagnosed as having new active pulmonary TB. Of these, 25 (30%), 15 with cavitary and 10 with noncavitary disease, met the entrance criteria of the study.
The baseline demographic, clinical, and laboratory characteristics of the study patients are given in Table 1. Patients with cavitary and noncavitary disease did not differ significantly with respect to age, ethnicity, symptom duration, smoking history, or BMI. Compared with patients with
DISCUSSION
We have presented structural (CT) and functional (PFT) data on 25 patients with culture-positive, drug-susceptible, pulmonary TB, 15 cavitary and 10 noncavitary. All patients were considered to have postprimary disease. The structural data confirm and extend the findings of Im et al6 who correlated the abnormalities seen on CT of the lung in postprimary TB with independent pathologic findings. We found, as they did, that endobronchial spread, presumably the result of passage of liquified
ACKNOWLEDGMENT
The authors are grateful to Lynda Mendella, research nurse, Dr. Mark Rigby and the staff of the Radiology Department, University of Manitoba, Dr. Dan McCarthy and the staff of the Pulmonary Function Laboratory, University of Manitoba, Dr. Bruce Light for his review, and Arlene Klassen and Kathy Harlos for their preparation of the manuscript.
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Supported by grants from the Manitoba Medical Service Foundation, the Sellers Foundation, and the Upjohn Company of Canada.