Does Normal Chest X ray in Patients with Chronic Cough Exclude Pulmonary tuberculosis?


ABSTRACT:BACKGROUND:Tuberculosis is the second infection in causing deaths from infectious agent in the world, currently in Iraq approximately 67% of new cases of Tuberculosis involve the lung only ,cough is the most common symptom of pulmonary Tuberculosis , pulmonary Tuberculosis nearly always causes detectable abnormalities on chest film, but still atypical or absent radiologic findings can occur.OBJECTIVE:This study was designed to determine whether in patients with chronic cough normal chest X ray exclude pulmonary tuberculosis.PATIENTS AND METHODS:One hundred seventy two patients attending the respiratory clinic, complaining from chronic cough and they are suspected cases of tuberculosis, were enrolled in this study. A full medical history and physical examination was done then a chest X ray was ordered, for those with normal chest X ray finding (seventy seven patients), sputum smear for acid fast bacilli (AFB) ordered .RESULTS:47 females (61%), 30 males (39%) with chronic cough with females to male ratio = 1.56/1.The age ranged between 17-67, with mean age of 37.16 years. The age of males ranged between 18-67 and the mean was 39.32 years, the age of females ranged between 17-66 and the mean was 34.93 years. X ray finding were negative in all the patients. Positive AFB in sputum smear examination by microscopy was found in only one patient but with ENT examination it was proved to be a case of laryngeal tuberculosis not pulmonary tuberculosis.CONCLUSION:Normal chest x ray in patients with chronic cough excludes pulmonary tuberculosis