Smear Negative Pulmonary Tuberculosis Is a Distinct Clinical Entity, Not a “Misdiagnosis Waste Basket”
No Thumbnail Available
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Medicine International Library
Abstract
Background: PTB can mimic many chronic lung diseases
resulting in misdiagnosis with serious consequences.
Objectives: To appraise all SN PTB patients who were
referred to us from lower health facilities after unsuccessful
treatment in order to confirm the appropriate diagnosis.
Methods: A cross sectional study at the pulmonary section
of our hospital.
Results: The median age of our patients was 46 with
interquartile range of 32 to 54 years. The commonest
presenting symptom was difficulty in breathing which was
present in almost 90% of them (30 out of 34), cough was
present in 24 with sputum production in 22 while haemoptysis
was reported in 3. All the 5 patients with malignancy reported
chest pain. Sixty eight percent of the patients were referred
from Peripheral TB DOT centers and sputum smear tests
were done in 82% of them while radiologic tests were done
in less than 50% of the patients. The final diagnoses include
COPD, malignancy, sarcoidosis, interstitial lung diseases
and fungal infection among others. Conclusion: Many lung
diseases are misdiagnosed as SN PTB because of similarity
in clinical presentation, overreliance on diagnostic test with
low TB detection and non adherence to local guidelines. We
advocate for WHO-recommended rapid molecular test for
all our suspected TB cases and prompt referral of difficult to
diagnose cases.
Description
Keywords
Negative Pulmonary Tuberculosis, Distinct Clinical Entity, Misdiagnosis Waste Basket