Abstract

Aim: To identify the atypical imaging features of tuberculosis on CT that presented as a diagnostic dilemma and to suggest possible factors responsible for the unusual presentation.

Methodology: Descriptive study conducted through collaboration of the Radiology Department and General Medicine department for a period of 12 months from October 2017 to October 2018. Patients with clinical suspicion of tuberculosis (TB), or patients who had TB as a valid differential, showing typical and atypical radiological features on CT were included in the study and were further followed up in medicine department. Patients with subsequent diagnosis of TB via clinical, radiological and pathological assessment were studied.

Results: A total of 300 patients were included in the study. 54 of 300 patients (18 %) showed atypical radiological features which presented with diagnostic difficulty. 33 of 54 (61%) patients with atypical imaging features were within the age group of 21 to 50 years. Socioeconomically patients either belonged to low class 261 of 300 (87.2%) or lower middle class 39 of 300 (13%). There were 45 cases of disseminated TB and 26 of these 45 cases (57.7%) were females. All females with disseminated disease were less than 40 years. 37 of 300 TB patients (12.3%) had concurrent diabetes. 3 patients simultaneously were diagnosed to have HIV co infection and 2 patients had pneumocystis co-infection with TB.

Conclusions: TB with atypical imaging is not uncommon and radiologists should be aware of these imaging features so they may not be misdiagnosed.

Keywords:Tuberculosis, Radiologist, Computed Tomography, Pneumocystis, HIV Coinfection, Diabetes, Socioeconomically.