Primary TB: Droplets infect alveolar macrophages → active TB within first 1-2 years (5%); contagious
Post-primary (reactivation) TB: Infection initially controlled by immune system (5%); viable dormant organisms reactivate at later date
Re-infection TB: Different DNA finger-printing between initial and subsequent infections
Latent TB: Noncontagious infected individuals that do not develop symptomatic disease (~ 90%)
Multidrug-resistant TB (MDR TB): Resistance to at least isoniazid and rifampin
Extensively drug-resistant TB (XDR TB): Resistance to isoniazid, rifampin, any fluoroquinolone, and at least 1 of 3 injectable second-line drugs (kanamycin, capreomycin, amikacin)
IMAGING
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
Microbiology
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Prognosis
Risk Factors
DIAGNOSTIC CHECKLIST
Consider
Selected References
Global Tuberculosis Report 2020. World Health Organization. 2020
Urbanowski ME et al: Cavitary tuberculosis: the gateway of disease transmission. Lancet Infect Dis. 20(6):e117-28, 2020
Carlesi E et al: How radiology can help pulmonary tuberculosis diagnosis: analysis of 49 patients. Radiol Med. 124(9):838-45, 2019
Furin J et al: Tuberculosis. Lancet. 393(10181):1642-56, 2019
Ankrah AO et al: Tuberculosis. Semin Nucl Med. 48(2):108-30, 2018
Poeta P et al: Tuberculosis in the 21th century: current status of diagnostic methods. Exp Lung Res. 44(7):352-60, 2018
Nachiappan AC et al: Pulmonary tuberculosis: role of radiology in diagnosis and management. Radiographics. 37(1):52-72, 2017
Kim W et al: CT and microbiologic follow-up in primary multidrug-resistant pulmonary tuberculosis. Acta Radiol. 57(2):197-204, 2016
Interrante JD et al: Exogenous reinfection as a cause of late recurrent tuberculosis in the United States. Ann Am Thorac Soc. 12(11):1619-26, 2015
Rozenshtein A et al: Radiographic appearance of pulmonary tuberculosis: dogma disproved. AJR Am J Roentgenol. 204(5):974-8, 2015
World Health Organization: Global tuberculosis report. 20th ed. Geneva: WHO Press, 2015
Ko JM et al: Pulmonary changes of pleural TB: up-to-date CT imaging. Chest. 146(6):1604-11, 2014
Kim HS et al: Serial CT findings of Mycobacterium massiliense pulmonary disease compared with Mycobacterium abscessus disease after treatment with antibiotic therapy. Radiology. 263(1):260-70, 2012
Song I et al: Tuberculous lymphadenitis of the thorax: comparisons of imaging findings between patients with and those without HIV infection. AJR Am J Roentgenol. 199(6):1234-40, 2012
Tiemersma EW et al: Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One. 6(4):e17601, 2011
Crampin AC et al: Recurrent TB: relapse or reinfection? The effect of HIV in a general population cohort in Malawi. AIDS. 24(3):417-26, 2010
Kim EY et al: Pulmonary mycobacterial disease: diagnostic performance of low-dose digital tomosynthesis as compared with chest radiography. Radiology. 257(1):269-77, 2010
Kliiman K et al: Predictors and mortality associated with treatment default in pulmonary tuberculosis. Int J Tuberc Lung Dis. 14(4):454-63, 2010
Jeong YJ et al: Pulmonary tuberculosis: up-to-date imaging and management. AJR Am J Roentgenol. 191(3):834-44, 2008
Chung MJ et al: Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. Eur Radiol. 16(9):1934-41, 2006
Heo JN et al: Pulmonary tuberculosis: another disease showing clusters of small nodules. AJR Am J Roentgenol. 184(2):639-42, 2005
Andreu J et al: Radiological manifestations of pulmonary tuberculosis. Eur J Radiol. 51(2):139-49, 2004
Neralla S et al: Mycobacterium tuberculosis: the treatment of active disease. Semin Respir Infect. 18(4):292-306, 2003
Choi YW et al: Tuberculous pleural effusion: new pulmonary lesions during treatment. Radiology. 224(2):493-502, 2002
Nakatsu M et al: Large coalescent parenchymal nodules in pulmonary sarcoidosis: "sarcoid galaxy" sign. AJR Am J Roentgenol. 178(6):1389-93, 2002
Lee JY et al: Pulmonary tuberculosis: CT and pathologic correlation. J Comput Assist Tomogr. 24(5):691-8, 2000
Cohen RA et al: Diagnosis of pulmonary tuberculosis using PCR assays on sputum collected within 24 hours of hospital admission. Am J Respir Crit Care Med. 157(1):156-61, 1998
Ellison E et al: Cytologic features of mycobacterial pleuritis: logistic regression and statistical analysis of a blinded, case-controlled study. Diagn Cytopathol. 19(3):173-6, 1998
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Tuberculosis (TB)
Mycobacterium tuberculosis (MTB)
Mycobacterium tuberculosis complex: M. tuberculosis, M. bovis, M. africanum, M. microti, M. canettii
Definitions
MTB: Airborne infection; person-to-person transmission via organism-containing droplets (1-5 μm)
Primary TB: Droplets infect alveolar macrophages → active TB within first 1-2 years (5%); contagious
Post-primary (reactivation) TB: Infection initially controlled by immune system (5%); viable dormant organisms reactivate at later date
Re-infection TB: Different DNA finger-printing between initial and subsequent infections
Latent TB: Noncontagious infected individuals that do not develop symptomatic disease (~ 90%)
Multidrug-resistant TB (MDR TB): Resistance to at least isoniazid and rifampin
Extensively drug-resistant TB (XDR TB): Resistance to isoniazid, rifampin, any fluoroquinolone, and at least 1 of 3 injectable second-line drugs (kanamycin, capreomycin, amikacin)
IMAGING
Radiographic Findings
CT Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
Microbiology
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
Prognosis
Risk Factors
DIAGNOSTIC CHECKLIST
Consider
Selected References
Global Tuberculosis Report 2020. World Health Organization. 2020
Urbanowski ME et al: Cavitary tuberculosis: the gateway of disease transmission. Lancet Infect Dis. 20(6):e117-28, 2020
Carlesi E et al: How radiology can help pulmonary tuberculosis diagnosis: analysis of 49 patients. Radiol Med. 124(9):838-45, 2019
Furin J et al: Tuberculosis. Lancet. 393(10181):1642-56, 2019
Ankrah AO et al: Tuberculosis. Semin Nucl Med. 48(2):108-30, 2018
Poeta P et al: Tuberculosis in the 21th century: current status of diagnostic methods. Exp Lung Res. 44(7):352-60, 2018
Nachiappan AC et al: Pulmonary tuberculosis: role of radiology in diagnosis and management. Radiographics. 37(1):52-72, 2017
Kim W et al: CT and microbiologic follow-up in primary multidrug-resistant pulmonary tuberculosis. Acta Radiol. 57(2):197-204, 2016
Interrante JD et al: Exogenous reinfection as a cause of late recurrent tuberculosis in the United States. Ann Am Thorac Soc. 12(11):1619-26, 2015
Rozenshtein A et al: Radiographic appearance of pulmonary tuberculosis: dogma disproved. AJR Am J Roentgenol. 204(5):974-8, 2015
World Health Organization: Global tuberculosis report. 20th ed. Geneva: WHO Press, 2015
Ko JM et al: Pulmonary changes of pleural TB: up-to-date CT imaging. Chest. 146(6):1604-11, 2014
Kim HS et al: Serial CT findings of Mycobacterium massiliense pulmonary disease compared with Mycobacterium abscessus disease after treatment with antibiotic therapy. Radiology. 263(1):260-70, 2012
Song I et al: Tuberculous lymphadenitis of the thorax: comparisons of imaging findings between patients with and those without HIV infection. AJR Am J Roentgenol. 199(6):1234-40, 2012
Tiemersma EW et al: Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS One. 6(4):e17601, 2011
Crampin AC et al: Recurrent TB: relapse or reinfection? The effect of HIV in a general population cohort in Malawi. AIDS. 24(3):417-26, 2010
Kim EY et al: Pulmonary mycobacterial disease: diagnostic performance of low-dose digital tomosynthesis as compared with chest radiography. Radiology. 257(1):269-77, 2010
Kliiman K et al: Predictors and mortality associated with treatment default in pulmonary tuberculosis. Int J Tuberc Lung Dis. 14(4):454-63, 2010
Jeong YJ et al: Pulmonary tuberculosis: up-to-date imaging and management. AJR Am J Roentgenol. 191(3):834-44, 2008
Chung MJ et al: Drug-sensitive tuberculosis, multidrug-resistant tuberculosis, and nontuberculous mycobacterial pulmonary disease in nonAIDS adults: comparisons of thin-section CT findings. Eur Radiol. 16(9):1934-41, 2006
Heo JN et al: Pulmonary tuberculosis: another disease showing clusters of small nodules. AJR Am J Roentgenol. 184(2):639-42, 2005
Andreu J et al: Radiological manifestations of pulmonary tuberculosis. Eur J Radiol. 51(2):139-49, 2004
Neralla S et al: Mycobacterium tuberculosis: the treatment of active disease. Semin Respir Infect. 18(4):292-306, 2003
Choi YW et al: Tuberculous pleural effusion: new pulmonary lesions during treatment. Radiology. 224(2):493-502, 2002
Nakatsu M et al: Large coalescent parenchymal nodules in pulmonary sarcoidosis: "sarcoid galaxy" sign. AJR Am J Roentgenol. 178(6):1389-93, 2002
Lee JY et al: Pulmonary tuberculosis: CT and pathologic correlation. J Comput Assist Tomogr. 24(5):691-8, 2000
Cohen RA et al: Diagnosis of pulmonary tuberculosis using PCR assays on sputum collected within 24 hours of hospital admission. Am J Respir Crit Care Med. 157(1):156-61, 1998
Ellison E et al: Cytologic features of mycobacterial pleuritis: logistic regression and statistical analysis of a blinded, case-controlled study. Diagn Cytopathol. 19(3):173-6, 1998
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