European Journal of Cardiovascular Medicine

Among the top 10 causes of death globally is tuberculosis. Chest radiography and sputum microscopy are the 2 basic investigations that are done to diagnose a case of pulmonary tuberculosis. Sputum CBNAAT is next diagnostic method of choice in sputum smear negative cases. The purpose of this study was to assess the link between chest radiography findings with method of microbiological detection. This study included 200 microbiologically confirmed cases of pulmonary tuberculosis that were diagnosed with either sputum microscopy (spontaneously produced or induced sputum) or sputum CBNAAT. Chest radiography findings were categorised based on type and location of lesions and extent of disease. Most common radiographic abnormality was consolidation, 61% of these were diagnosed on microscopy of spontaneously produced sputum. 70% patients of cavitary lesions and 80% with abscess were diagnosed on microscopy. Diagnostic yield of microscopy was less in lymphadenopathy and those with minimal lesions on chest radiography. All cases of miliary pattern (n=4) were detected on sputum CBNAAT. Sputum microscopy is fairly easy and sensitive method of diagnosis of pulmonary tuberculosis. With microscopy, patient can be diagnosed and started on treatment in single visit to healthcare facility. Sputum CBNAAT is more sensitive technique but due to requirement of higher expertise and specialized equipment, it’s not available at most of the peripheral centres. Sputum CBNAAT is the next diagnostic method of choice for sputum smear negative cases but due to unavailability, either sample or patient is to be transferred to higher centre which further delays the diagnosis and initiation of treatment. Apart from paediatric and HIV/AIDS patients, we suggest that sputum CBNAAT should be used for diagnosis of cases with miliary pattern and minimal involvement to shorten the time to diagnosis and initiation of treatment.