Abstract

OUTCOME OF PATIENTS PRESENTING AS SPUTUM AFB SMEAR NEGATIVE AND X-RAY CHEST LESION IN A TERTIARY CARE CENTRE

Dr. Ronald Win B.* and Dr. C. Sudheendra Ghosh

Abstract

When a patient present with pulmonary symptoms and sputum smearfor AFB is negative with X-ray chest lesions, the chance of pulmonarytuberculosis is very high in our setting. But it can be other conditionslike Pneumonia, malignancy, Bronchiectasis etc. So understanding theoutcome of a patient presenting as sputum AFB negative withradiological lesions in a tertiary care centre is important for earlydiagnosis and treatment of different conditions including smearnegative pulmonary tuberculosis. Primary Objective: To find out theoutcome of sputum AFB smear negative patients presenting withpulmonary symptoms and radiological lesions. Secondary objective:What is the proportion of patients presenting as pulmonary tuberculosis and its radiologicalfeatures. Study design: Prospective study. Study Setting: Department of Pulmonarymedicine, Govt. Medical College, Trivandrum. Methodology: A total of 398 patients weresubjected for detailed investigations and grouped into different conditions like Pneumonia,malignancy, Bronchiectasis etc. The undiagnosed cases after initial evaluation were subjectedfor cat I ATT and the response is observed. In addition to the undiagnosed cases, thosepatients excluded from the study and death occurred during the study period were alsocalculated and the total outcome is measured. Conclusion: Out of 398 patients, 162 (40.70%)were pulmonary tuberculosis cases between the age group of 45-75 years. The next mostcommon conditions were Pneumonia 79 (19.85%), malignancy 74 (18.59%) andBronchiectasis 26(6.53%). This is followed by Lung abscess 12(3.02%) and ILD 5(1.26%). 15 (3.77%) were having other diagnosis which includes sarcoidosis, wegners and Pneumoconiosis.

Keywords: Outcome, Smear negative radiological lesion, tertiary care centre.