RADIOGRAPHIC FINDINGS AND PATTERNS IN MULTIDRUG-RESISTANT TUBERCULOSIS

Multidrug-resistant tuberculosis (MDR TB) is prevalent in urban areas with large HIV-positive populations. We retrospectively evaluated the chest radiographs of MDR TB patients at presentation and compared them to patients with drug-sensitive tuberculosis (DS TB). Although the ov erall radiographic findings and patterns of MDR TB and DS TB were simi lar, there were significant differences among the MDR TB patients depe nding on how MDR TB was acquired. Patients who developed MDR TB during an outbreak showed noncavitary consolidations, pleural effusions, and a primary radiographic pattern (70%). On the other hand, patients who acquired MDR TB due to noncompliance with antituberculous therapy oft en had cavitary consolidations (50%) and generally demonstrated a post primary radiographic pattern. Cavitation occurred equally in patients with MDR TB who are HIV positive regardless of CD4 cell count. Chest r adiographic findings and patterns in MDR TB are most accurately interp reted in conjunction with clinical history, specifically prior TB trea tment. Nevertheless, approximately one-third of patients did not show the ''expected'' radiographic pattern.