CLINICAL SPECTRUM OF PULMONARY AND PLEURAL TUBERCULOSIS - A REPORT OF5,480 CASES

The aim of the present study was to investigate the epidemiological, c linical, laboratory and radiological features of patients with active pulmonary tuberculosis (TB) (with or without pleural involvement) or w ith pleural TB (in the absence of radiological parenchymal disease). A systematic predetermined form, including 60 items regarding the above -mentioned features, was completed for 5,480 patients, Sputum smear an d culture data, radiological findings, and additional extrapulmonary i nvolvement were evaluated in the patients with pulmonary TB (n=5,094). Epidemiological features, and other clinical and laboratory character istics were investigated in all patients (n=5,480). TB was more common among persons aged 20-39 yrs, males, and those living in large urban centres in our region. There were 4,268 newly detected patients (78%), and 1,212 active ex-patients (22%) who had history of previous antitu berculosis treatment. Additional extrapulmonary involvement was found in 455 patients (9%). Sputum samples were smear-positive in 3,916 (79% ), and culture-positive in 3,748 cases (76%). Most common radiological patterns were parenchymal infiltrate in 5,017 (99%), and cavitation i n 3,363 (66%). Unusual radiological patterns were also noted, i.e, low er lung field TB (LLFTB) in 317 cases (6.2%), pneumothorax in 78 cases (1.5%), and miliary pattern in 66 cases (1.3%). In conclusion, becaus e of the more frequent occurrence in the younger age group, it is cons idered that the prevalence of disease is still high and that the trans mission of tubercle bacilli is not decreasing in our region. The highe st risk group consisted of male subjects and those living in urban cen tres. The high percentage of active ex-patients suggests that new cont rol programmes for tuberculosis are required in Turkey.