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Tuberculosis

Minimal PTB

06/30/2009

Question:

I was diagnosed minimal PTB last 2002, but I only took medicine last 2006. I did all my doctor said like CT scan, sputum and lot of xrays. After my medication my doctor says that it`s ok now. This is my last result of my xray which said left upper lobe nodular densities has no change. I did xray again outside and it said left subclavicular fibronodular infiltrates due to PTB. My doctor said that its only a scar -- that it can`t be cured by medicine but in surgery. Is it true? Is there any option or medicine for this and why when I did xray the finding was not a scar? Thank you.

Answer:

Sometimes it is difficult for us to answer a question when we do not have all of the facts.

I am not sure what “minimal PTB” is. I am also not sure if you were diagnosed and treated for “active” TB disease (symptoms of fevers, chills, and cough, night sweats) or you were diagnosed and treated for latent TB infection (no signs or symptoms of TB disease, positive tuberculin skin test).

If the dates you listed are correct, (diagnosed in 2002 and treated in 2006), then you most likely did NOT have active TB disease. Your doctor must have been concerned about active TB disease by ordering sputa and CT scans.

After an infection of the lung with TB, you will have areas that are abnormal on CXR or CT scan. These areas may or may not improve after you have completed treatment. Your medical doctor may refer to these abnormal areas as “scars” and the radiologist may refer to these same areas in radiological terms. Other infections such as bacterial, fungal, and even non-infectious causes such as chemicals can cause abnormalities on CXR.

What is important is that you were medically evaluated for the abnormal areas, treated, and the areas are not getting worse. If you are having pulmonary symptoms of shortness breath, fever, weight loss, fatigue or chest pain then you will need further evaluation.

In the future, if you were to get another CXR or CT scan of the chest, be sure to let your doctors know that you had an abnormal CXR/CT scan in the past. Then the doctors can compare your new radiological studies to the old ones to determine if there is no change in these areas or if there is a NEW area of abnormality.

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Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University