LOWER LUNG FIELD TUBERCULOSIS: AN ANALYSIS OF 146 CASES

Medical records of 146 patients with lower lung field tuberculosis were reviewed. There was a female to male ratio of5: 4. More than 75% of patients were under 35 years of age and average duration of symptoms before diagnosis was less than one month in 7% , between 1 -6 months the in 63 % and more than 12 months in 10% of our patients. PPD test was positive in 80% and direct sputum smear for acid-fast bacilli was positive in 88% of cases. Radiologically, tuberculous lesion was limited to right lower lobe (RLL) alone in more than 50% , left lower lobe (LLL) alone in 35% , while bilateral lower lobe involvement was found in 15% of our patients. Superior segments of right and left lower lobes were the most commonly involved segments respectively. Pulmonary infiltrates were nonhomogenous in more than 80% of cases while homogenous pneumonia-like consolidations were found in 15% of our series. 6 6% of patients had cavitary changes with air-fluid levels in 20%. Hilar adenopathy alone or in combination with paratracheal adenopathy was found in chest x-rays of 9% of cases. Fasting and two hour postprandial blood sugars were measured in 98 patients. Seven (7.1 %) had overt diabetes mellitus and all of them were diabetic at the time of diagnosis of tuberculosis. Five pregnant women, a medical student, a radiology technician, an old male with metastatic carcinoma of unknown primary origin under chemotherapy, a middle-aged woman with rheumatic heart disease (mitral stenosis) who acquired tuberculosis of superior segment of RLL after valve replacement, an old female with rheumatoid arthritis on nonsteroid anti-Inflammatory agents, a male with history of alcohol intake, a young male with alopecia totalis and a young female with tuberous sclerosis were included among our patients.