Multidrug-resistant tuberculosis versus drug-sensitive tuberculosis in human immunodeficiency virus-negative patients: computed tomography features.

OBJECTIVES

To compare the computed tomography (CT) features of patients with multidrug-resistant tuberculosis with those of patients with drug-sensitive tuberculosis in a country not associated with the human immunodeficiency virus (HIV) epidemic.

METHODS

The CT images of 47 patients with multidrug-resistant tuberculosis were compared with those of 47 patients with drug-sensitive tuberculosis as a control group. Each multidrug-resistant tuberculosis patient was age (decade) and gender matched to a drug-sensitive tuberculosis patient. All patients were seronegative to HIV. This study evaluated the presence of centrilobular nodules, consolidation, emphysema, bronchiectasis, lung destruction, calcified granuloma, cavitation, pleural effusion, and lymphadenopathy. A statistical comparison was performed by using the Fisher exact test for univariate analysis and a multiple logistic regression method for multivariate analysis.

RESULTS

In univariate analysis, bronchiectasis, lung destruction, a calcified granuloma, and cavitation were more frequently observed in multidrug-resistant tuberculosis than in drug-sensitive tuberculosis. Multivariate analysis showed that cavity formation was the only significant difference between multidrug-resistant tuberculosis and drug-sensitive tuberculosis. In patients with cavitary tuberculosis, multiple cavities (>3 cavities) were observed only in patients with multidrug-resistant tuberculosis.

CONCLUSIONS

Most patients with multidrug-resistant tuberculosis had cavity formation on CT. Although the presence of a cavity does not mean multidrug resistance, multiple cavities suggest the possibility of multidrug-resistant tuberculosis.