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Chest, Vol 101, 1309-1311, Copyright © 1992 by American College of Chest Physicians

ARTICLES

Whole lung tuberculosis. A disease with high mortality which is frequently misdiagnosed

TC Tsao, YC Juang, YH Tsai, RS Lan and CH Lee
Department of Chest Medicine, Chang Gung Memorial Hospital, Taiwan, Republic of China.

The mortality rate of WLTB was significantly higher than non-WLTB in 45 of 516 cases of PTB in a 24-month period. There is no known underlying disease predisposing to WLTB. Clinically, the patients were significantly more toxic and had lower serum albumin and hemoglobin levels than non-WLTB patients. They had a lower rate of positive PPD tuberculin skin tests. The chest roentgenograms revealed three patterns: (1) DBS type in 15--all with multiple or diffuse opacities with or without cavitations; (2) DHS type in 20--eight with typical miliary lesions and 12 with atypical miliary patterns; (3) combined focal PTB and DHS type in ten. We found that atypical chest roentgenographic patterns were common in WLTB and frequently led to misdiagnosis. The delayed diagnosis and treatment of this advanced disease resulted in the high mortality. Early, empirical antituberculosis chemotherapy is indicated and life-saving.




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Copyright © 1992 by the American College of Chest Physicians.