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|Title: ||The past and present radiographic manifestations of pulmonary tuberculosis at Mulago Hospital|
|Authors: ||Iga-Matovu, Deogras|
|Keywords: ||Pulmonary tuberculosis|
|Issue Date: ||Apr-1989 |
|Abstract: ||A cross-sectional study of the chest radiographs of adult tuberculosis patients, seen at Mulago Hospital, in 1972, 1979 and 1988 was carried out between August and December 1988.
The aim of the study was to determine the past and present radiographic manifestations of pulmonary tuberculosis with the hope of demonstrating the presence or absence of a changing pattern in the radiographic manifestation of the disease and probably come up with an explanation as to the possible cause.
Clinical notes and chest radiographs of 96, 106 and 205 patients seen in 1972, 1979 and 1988, respectively, were studied. The clinical notes were analysed for symptoms, laboratory results and heaf test results. The chest radiographs were analysed for radiographic signs. 38 of the 205 patients seen in 1988 had undergone the ELISA test.
There was gradual increase in the number of young adults and females presenting with pulmonary tuberculosis, over the years. The symptomatology was little changed, with only hemoptysis being significantly less frequent in 1988 than in 1972 and 1979. Sputum negativity, for AAFBs, was commoner in 1988 (3.9%) than in 1972 (0.9%). The sputum negative patients had either positive cervical lymph node or pleural biopsies or both.
Of the 38 patients tested for HIV seropositivity, 28 (73.4%) were positive and only 10 (35.7%) of these were females. The symptomatology was not much different from the non-tested group. Hemoptysis was less common among the HIV seropositive patients (10.7%) than the HIV seronegative (30%). Sputum negativity was seen only among HIV seropositive patients (14.3%). Positive cervical lymph node and pleural biopsies were seen in 7.1 % of HIV seropositive patients for each.
Significant differences were observed in the radiographic features over the years. More patients were presenting with features of primary tuberculosis in 1988 than in 1972 and 1979. There was gradual decrease in the number of patients presenting with fibro-nodular opacities, fibrosis, cavitation, lung collapse, and calcifications over the years. On the other hand, there was gradual increase in the number of patients presenting with diffuse infiltrates, pleural effusion, hilar and mediastinal lymphode enlargement.
The above trend was magnified among the HIV seropositive patients. Less upper lobar lesions were seen in the HIV seropositive patients than the HIV seronegative ones and the reverse for lower lobe infiltrates.
Normal chest x-rays were seen in 2 patients (1%) of the 1988 group, both of whom were HIV seropositive. One patient (1%) had a normal chest x-ray in the 1972 group. No significant differences were noted in the frequency of massive consolidation, nodular opacities, pneumothorax and emphysema, over the years although miliary nodular opacities were less common among HIV seropositive patients than HIV seronegative ones.|
|Description: ||A dissertation submitted for the award of the degree of Master of Medicine in Radiodiagnosis of Makerere University|
|Appears in Collections:||Theses & Dissertations (Sch. of Med.)|
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