Julio A. Leey, MD; W. Paul McKinney, MD
Potential Financial Conflicts of Interest: None disclosed.
Leey J., McKinney W.; Radiographic Appearance of Primary Tuberculosis. Ann Intern Med. 2007;146:395. doi: 10.7326/0003-4819-146-5-200703060-00016
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Published: Ann Intern Med. 2007;146(5):395.
TO THE EDITOR:
During a recent morning report at the University of Louisville Hospital, a case of primary tuberculosis was presented that was accompanied by a discussion of the recent Update in Infectious Diseases by Lorber (1). The Update highlighted an earlier article (2) that described predictors of the radiographic appearance of tuberculosis.
The original article was a retrospective cohort study based on all adult patients with culture-proven pulmonary tuberculosis at Columbia University Medical Center between 1990 and 1999. Clustered cases (≥2 cases with same strain by restriction fragment length polymorphism analysis) were assumed to be due to recent transmission, indicating primary tuberculosis, and unique cases (unique strains) were considered to represent reactivation of latent disease or secondary tuberculosis. Upper lobe infiltrates or cavitary lesions in the upper lobe were considered to constitute a typical film; otherwise, results were deemed atypical.
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