Table. Clinical and laboratory characteristics of patients suspected of having false-positive cultures for Mycobacterium tuberculosisa.
Patient | Lab | Specimen type | Initial or follow-up specimen | Sputum smear result | Clinical signs and symptoms | Comments | Panel decision | Final diagnosis |
---|---|---|---|---|---|---|---|---|
1 | 1 | Sputum | Initial | Negative | 36-yr-old man with AIDS hospitalized with cough, dyspnea, right lower lobe infiltrate; he improved with trimethoprim and sulfamethoxazole alone | Genotype of isolate matched that of another patient whose specimen was processed same day | Cross-contamination | Bacterial pneumonia |
2 | 2 | Sputum | Initial | 2+ Positive | 28-yr-old man with HIV infection with fever, cough, right lower lobe infiltrate; improved with ceftazidime | Genotype of isolate matched that of another patient hospitalized on the same ward | Mislabeled specimen | Bacterial pneumonia |
3 | 2 | Sputum | Initial | Negative | 31-yr-old woman hospitalized with cough, left lower lobe infiltrate, and leukocytosis; chest radiograph showed improvement with clindamycin and ofloxacin | Genotype of isolate matched that of another patient whose specimen was processed same day | Cross-contamination | Bacterial pneumonia |
4 | 2 | Sputum | Initial | Negative | 44-yr-old man hospitalized with cough and right lower lobe infiltrate; improved with levofloxacin before anti-TB therapy initiated | Genotype of isolate matched that of another patient whose specimen in the BACTEC instrument immediately preceded the case patient | Cross-contamination | Lung abscess |
5 | 2 | Sputum | Follow-up | Negative | 68-yr-old woman newly immigrated from China with cough; chest radiograph showed bi-apical fibronodular changes | Genotype of second isolate >30 days later did not match that of initial isolate or any other isolate in database | Mislabeled specimen or mixed infection | Bacterial pneumonia versus TB with mixed infection] |
6 | 2 | Sputum | Initial | 4+ Positive | 82-yr-old man with cough, fever; chest radiograph showed chronically increased right mid-lung interstitial markings | Genotype of isolate matched that of another patient hospitalized on the same ward | Mislabeled specimen or cross-contamination | Bacterial pneumonia |
7 | 2 | Sputum | Initial | Negative | 27-yr-old woman with upper respiratory symptoms; chest radiograph was normal | Genotype of isolate matched that of another patient whose specimen was processed same day | Cross-contamination | Upper respiratory tract infection |
8 | 2 | Sputum | Initial | Negative | 44-yr-old man with hemoptysis and known pulmonary metastases of squamous cell carcinoma of trachea; chest radiograph showed three large cavities with air-fluid levels; bronchoscopy culture grew H. influenzae, and patient improved on antibiotics alone | Genotype of isolate matched that of another patient whose specimen was processed same day | Cross-contamination | Lung abscess |
9 | 2 | Broncho-alveloar lavage | Initial | Negative | 55-yr-old woman hospitalized with dyspnea and left lower lobe infiltrate; she improved with broad-spectrum antibiotics alone | Genotype of isolate matched that of another patient whose specimen was processed same day | Cross-contamination | Bacterial pneumonia |
10 | 3 | Sputum | Follow-up | Negative | 34-yr-old homeless man with HIV infection, fever, and cervical lymphadenopathy; chest radiograph showed left lung nodule | Genotype of initial isolate matched that of another homeless TB patient; follow-up specimen (35 days later) had a unique genotype | TB | TB |
aLab, laboratory; TB, tuberculosis; H. influenzae, Haemophilus influenzae.