II. Precautions
-
Tuberculosis may cause a typical lobar infiltrate
- Include Tuberculosis in the differential in higher risk patients
III. Imaging: Findings in Active Tuberculosis
- Cavitary Lung Lesion (higher risk for infectious spread to contagious contacts)
- Upper lobe cavitary lesion or infiltrate
- Apical and posterior segments often affected
- Superior segment of lower lobes may also be affected
- Ghon Complex (pathognomonic)
- Healed primary peripheral nodular infiltrate
- Calcified hilar node
-
Miliary lesions (disseminated spread throughout lung)
- Associated with capillary lesions
- Associated with Immunocompromised conditions (e.g. AIDS)
- HIV positive Chest XRay correlates with CD4 Count
- CD4 Cell Count <200
- Mediastinal adenopathy
- CD4 Cell Count >200
- Upper lobe infiltrates and cavitation
- CD4 Cell Count <200
- Other non-specific changes
- Findings not suggestive of prior Tb fibrotic lesion
- Isolated Granuloma on Chest XRay