Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis

Park, Seung Kyu; Kweon, Eun Soo; Song, Sun Dae

Abstract

BACKGROUND
Pulmonary tuberculosis with a remaining cavitary lesion is considered to be a problem with the course of treatment. In particular, re-treatment cases tend to respond poorly to current anti-tuberculosis agents. Therefore the factors that are related with the poor closure of a cavitary lesion in pulmonary tuberculosis during treatment were evaluated.
METHODS
A retrospective review of the medical records and chest X-ray films of 68 patients who had chemotherapy for the pulmonary tuberculosis with cavitary lesions was made. All the patients had been followed up for more than 12 months at National Masan Tuberculosis Hospital as of Aug. 2000.
RESULTS
The male to female ratio was 3.9:1. 72.4% of the patients were between 20 to 50 years of age. 66.2% of the cavitary lesions on the chest X-ray films were confined to the upper lung fields : 36.8% in the right upper lung field and 29.4% in the left upper lung field. 82.4% of the cavities were less than 40mm in their size, and 83.8% were less than 6mm thick. The cavitary lesions were closed in 48 cases and remained in 20 cases during a follow-up period of more than 12 months. The factors that are though to affect ot the outcomes of the cavities were age, past medication history, the number of unused drugs, and the number of sensitive drugs.
CONCLUSION
In the treatment courses of pulmonary tuberculosis with cavitary lesions, the following factors are associated with less desirable outcome:an age over 45, a past medication history of more than 2 courses of treatment, The number of unused drugs not exceeding average 6 and the number of sensitive drugs not exceeding average 7.