الفهرس 
Pulmonary tuberculosisOnly 14 pages are availabe for public view
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Abstract
This study was conducted at Shebin Elkom Chest Hospital and it was a retrospective study where data were recruited from patients’ files at hospital archives from June 2019 to June 2020. The study included the analysis of 530 patients’ files divided into 200 files for sputum negative pulmonary tuberculosis [group I] and 330 files for extrapulmonary tuberculosis [group II (group IIa: 80 patients with pleural TB & group IIb: 75 patients with TB meningitis & group IIc: 65 patients with TB lymphadenitis & group IId: 60 patients with peritoneal TB and group IIe: 50 patients with urinary TB)].
Study Procedures:
Data were recruited from the files of patients and included:
1. Patient history.
2. Clinical general and local chest examination.
3. Laboratory investigations: a) Sputum samples [in group I] or other biological samples [in group II (pleural fluid, CSF, lymph node fine needle aspirate, ascitic fluid, urine)] analysis for ZN stain smear microscopy, LJ Culture for AFB and Gene Xpert MTB/RIF.
b) Blood samples: ESR, Liver and kidney function, CBC, blood Glucose level, HIV antibody titre by ELISA.
4. Radiological investigations according to the system affected as plain Chest X-ray, chest computed tomography, brain CT, CT neck, triphasic CT abdomen and pelvis, urinary tract CT.
5. Tuberculin skin test (TST).
6. In cases of pleural TB, pleural fluid analysis [bacteriologically, biochemically (LDH, proteins and ADA) and cytologically] was done for all cases. Blind or thoracoscopic pleural biopsy was performed in some cases that were not diagnosed by pleural fluid analysis including LJ culture, and they were added to the pleural fluid culture as a gold standard for diagnosis of pleural TB in this group [CRS (composite reference standard) which includes pleural fluid smear and culture & histopathology/smear+culture of pleural biopsy, biochemical and cytological analysis of the fluid and/or improvement on anti tuberculous treatment].
7. In the group of TB lymphadenitis, lymph node biopsy or fine needle aspirate were taken and histopathological examination was done for the lymph node biopsies and was added to the culture as a gold standard for diagnosis of TB in this group [CRS (composite reference standard) which includes fine needle aspirate smear+culture & histopathology/smear+culture of lymph node biopsy].
Our results showed that in group I; as compared to the LJ culture that is considered the gold standard for TB diagnosis, the sensitivity of gene Xpert was 80.23%, the specificity was 95.7%, the PPV was 93.24% and the NPV 86.7% and the accuracy was 90%.
In group II (extrapulmonary TB); as compared to the LJ culture that is considered the gold standard for TB diagnosis, the sensitivity of gene Xpert was 85.3%, the specificity was 93.33%, the PPV was 96.48% and the NPV 74.8% and the accuracy was 87.87%.