Presentation

Tuberculosis is most frequently manifested clinically as pulmonary disease, but it can involve any organ. Extrapulmonary TB accounts for about 20% of disease in HIV-seronegative persons but is more common in HIV-seropositive persons. Pulmonary TB typically manifest with fever, night sweats, chronic cough, sputum production, hemoptysis, anorexia, and weight loss. Chest radiographs in patients with pulmonary TB typically reveal upper-lobe cavitary lesions and can reveal infiltrates or nodular lesions, as well as lymphadenopathy (Figure 16-2). TB in the setting of advanced HIV co-infection does not generally manifest in the typical manner (Table 16-5).

Figure 16-2 Chest radiograph showing right apical infiltrate typical of a patient with primary tuberculosis.

(From Fitzgerald D, Sterling T, Haas D. Mycobacterium tuberculosis. in Mandell GL, Bennett JE, Dolin R (eds). Mandell, Douglas, and Bennett's Principles and Practice of infectious Diseases, 7th ed. Philadelphia, Churchill Livingstone, 2010, p 3141.)

Figure 16-2 Chest radiograph showing right apical infiltrate typical of a patient with primary tuberculosis.

(From Fitzgerald D, Sterling T, Haas D. Mycobacterium tuberculosis. in Mandell GL, Bennett JE, Dolin R (eds). Mandell, Douglas, and Bennett's Principles and Practice of infectious Diseases, 7th ed. Philadelphia, Churchill Livingstone, 2010, p 3141.)

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