Table 3.

Patients with positive immunospot test with symptoms suggestive of possible TB, abnormal chest radiograph or positive sputum culture

Patient	Country of origin	CD4 (cells/ul)	Receiving HAART	Clinical features	Chest radiograph	Sputum culture	Other investigations	Treatment	Final diagnosis
1	Zimbabwe	413	Yes	No symptoms	Normal	Positive M. tuberculosis – fully sensitive		2RHEZ, 4RH	Pulmonary TB
2	Cameroon	350	No	Posterior cervical lymphadenopathy	Normal	None received	FNA cervical lymph node, culture negative	2RHZ	LTBI
3	Turkey	331	Yes	Back pain and spinal tenderness	Normal	None received	MRI spine normal	6H	LTBI
4	Burundi	843	No	Memory problems; schizoaffective disorder Recent weight loss	Normal	Negative	MRI brain - normal	6RHZ	Presumed TB (weight increased on treatment)
5	Congo	437	No	Weight loss 7 kg; anaemia, hypertension	Reported normal, but review suggested Left hilar lymph nodes	Negative	CT scan: 8 mm axillary lymph nodes; ground glass shadowing right paravertebral region	2RHZ	LTBI
6*	Jamaica	539	No	Paranoid schizophrenia	Large emphysematous bullae	Negative	Inflammatory markers	6H	LTBI
7*	Nigeria	402	Yes	No symptoms	Blunting of left costophrenic angle	None received	Inflammatory markers	6H	LTBI
8	Kenya	168	Yes	No symptoms	Bronchopneumonia 2 months before; now normal chest radiograph	Negative	Inflammatory markers	6H	LTBI
9	Angola	1372	Yes	No symptoms; cardiac murmur	Minor left basal shadowing – no evidence of TB	Negative	Inflammatory markers	6H	LTBI
10	Uganda	980	Yes	No symptoms	Peribronchial thickening within the right perihilar region	Negative	Other investigations ordered but not received	6H	Isoniazid-resistant TB 2 years later
11	UK	345	No	Epilepsy	Left hilum appears bulky	Negative	CXR at 6 months no change	3RH	LTBI
12	Guinea Bissau	1028	Yes	Chest pain ? pericarditis	Blunting left costophrenic angle	Negative	Normal echocardiogram	6H	LTBI
13	Nigeria	414	Yes	Chronic cough; inguinal lymph nodes (follicular hyperplasia)	Right paratracheal region abnormal and right hilum. Reviewed by radiology team and considered normal	Negative	Inflammatory markers	6H	LTBI
14	Zambia	829	Yes	General aches	2cm lung nodule	Negative	Vitamin D levels low	6H	LTBI
15	Ghana	122	Yes	Fevers and sweats for 7 months (previously denied any symptoms)	1 cm nodule medial to left superior pulmonary vein with blunting left costophrenic angle	PositiveM. tuberculosis isolated – fully sensitive	CT scan – extensive cervical lympadenopathy, left upper zone infiltration and splenomegaly, FNA – TB	2RHEZ, 4RH	Pulmonary and lymph node TB

*Borderline results as defined by the CDC, United States [4].

HAART, antiretroviral therapy; TB, tuberculosis; CXR, chest radiograph; LTBI, latent tuberculosis infection; FNA, fine needle aspirate; MRI, magnetic resonance imaging; CT, computerised tomography.

All patients had a chest radiograph and were offered induced sputum for mycobacterial culture in addition to inflammatory markers.

Drug regimens are abbreviated to the number of months of treatment, followed by letters for the drugs administered: H, isoniazid; R, rifampicin or rifabutin; Z, pyrazinamide; E, ethambutol.