Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis

Park, Seung Kyu; Choi, In Hwan; Song, Sun Dae

Abstract

OBJECTIVE
Cavitary lesion in pulmonary tuberculosis sometimes makes problems in the course of treatment. Especially, retreatment cases tend to respond poorly to current antituberculosis agents. So, authors tried to render a guideline for clinical approach toward cavitary lesions in pulmonary tuberculosis.
METHODS
Retrospective analysis of 33 pulmonary tuberculosis patients with cavitary lesions was made. All the patients had got treatment at National Masan Tuberculosis Hospital from Jan. 1995 to Aug. 1995.
RESULTS
The ratio between male and female was 10:1. Age distribution was 69.7% in 3rd and 4th decades. The locations of cavitary lesion were 60.6% in right upper lung field and 36.4% in left upper lung field. In the extent of disease, there were 12 cases(36.4%) in moderate advanced and 21 cases in far advanced. Cavitary lesions were closed in 5 cases and remained in 28 cases. In the cases of closed cavity, it was happened within 10.6+/-4.72 months after they took treatment, the size of cavity was 35.5 +/-17.1 in long diameter, 27.0+/-12.2 in short diameter and 4.6+/-2.1 mm in wall thickness. In the cases of remained cavity, the size of cavity was 31.9 +/-12.3 in long diameter, 21.0+/-9.8 in short diameter and 5.04+/-2.0 mm in wall thickness. In terms of negative conversion, it took 3.8 +/-2.17 months in the case of closed cavity but it was happened within 5 months for only 4 patients in the case of remained cavity. In the point of past medication history, there was none in closed cavities but there were none in 1 case, once in 3 cases, two times in 9 cases and more than three times in 13 cases among remained cavitary lesions.
CONCLUSION
In the retreatment cases of pulmonary tuberculosis with cavitary lesions, they tend to respond poorly to current antituberculosis agents. So, if the lesions are localized, operative intervention may be a proper method as adjunctive treatment.