To treat or not to treat tuberculosis –clinical decision making in patients with previous pulmonary tuberculosis using 18F-FDG PET/CT

Post-tuberculosis (TB) radiological changes and symptoms can mimic TB. PCR-based diagnostic tests can show positive results, suggesting the presence of Mycobacterium tuberculosis DNA in the absence of viable bacteria. We present a case with two episodes of previous TB. Despite workup including trace...

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Bibliographic Details
Published in:Respiratory medicine case reports 2023, Vol.46, p.101932, Article 101932
Main Authors: Günther, Gunar, Abu- Hussain, Nebal, Keller, Peter M., Guler, Reto, Mukasa, Sandra L., Wolmarans, Karen, Thienemann, Friedrich
Format: Article
Language:English
Subjects:
18F-FDG PET/CT
False-positive
recurrent
Tuberculosis
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Summary:Post-tuberculosis (TB) radiological changes and symptoms can mimic TB. PCR-based diagnostic tests can show positive results, suggesting the presence of Mycobacterium tuberculosis DNA in the absence of viable bacteria. We present a case with two episodes of previous TB. Despite workup including trace to low positive PCR results, after performing sputum analysis, bronchoalveolar lavage analysis, cyto-brush and 18F-FDG PET/CT guided transthoracic biopsy, no culturable mycobacteria were detected. 18F-FDG PET/CT showed a high metabolic activity of the biopsied lesions. More accurate strategies and tools in patients with previous TB and positive PCR results are required to make appropriate treatment decisions.
ISSN:2213-0071
2213-0071
DOI:10.1016/j.rmcr.2023.101932