Aspectos clínicos e radiológicos da tuberculose pulmonar em usuários do hospital universitário João De Barros Barreto, Belém-Pará, no período de abril de 2003 à março de 2004

Abstract

The familiarization with several radiographic manifestations of tuberculoses is basic for the precocious diagnosis and the reduction of it morbi-mortality. This research has the objective to analyze the most prevalent chest radiographic alterations observed in the Hospital Universitário João de Barros Barreto’s patients as well as social-demographic aspects, other auxiliary diagnostic methods, clinical manifestations, other associated forms of tuberculosis presentation and associated diseases. A review was made of the medical record cards and chest X-ray of 139 patients with pulmonary tuberculosis attended during the period of April 2003 to March 2004. For the statistics analysis was used Excel® 2003 program. Of the 139 patients, 82 (59.0%) had presented heterogeneous condensation, 48 (34.5%) cavitary image, 22 (15.8%) alveolar opacity, 18 (12.9%) assorted opacity, 11 (7.9%) interstitial opacity diffuse reticulum nodular type, 10 (7.2%) pulmonary image of consolidation, two (1.4%) image of numular condensation, one (0.7%) interstitial opacity of peri-rough-vascular type and one (0.7%) with a normal x-ray. From the total of the sample, 77 (55.4%) patients had presented typical images of pulmonary TB and 62 (44.6%) atypical images. The population was predominantly masculine (63.3%), and the most of the people searched are single (62.6%), with age average of 38,5 ± 18,8, coming from the capital (55.4%), with schooling equal or less than 7 years (70.5%) and were brown (86.3%). The internment average was 17,2 days. Positive sputum bacilloscopy was found in 93 patients, negative sputum bacilloscopy in 36 (25.9%) and 10 (7.2%) had not carried through bacilloscopy. The most common clinical manifestations were cough, fever, weight loss and expectoration, followed by toracic pain, dyspnoea and hemoptisis. Pleural tuberculosis was the most common extra-pulmonary localizations (11,5%). The most common associated disease was alcoholism, wich was found in 40 (28.8%) patients. The conclusions from this study analysis, the most common radiographic image found was heterogeneous condensation (59%), with or without cavitations, preferentially in superior lobes. Making the correlation between radiographic image and it respective localization, the typical radiological manifestation compared with atypical manifestation created a proportion of 1:1 approximately, opposing the initial expectation that would be the prevalence of atypical images.