Table 1.
Demographic and clinical characteristics, and laboratory and imaging findings in patients with pseudotumoral pulmonary tuberculosis, University la Rabta Hospital, Tunis, Tunisia
| Patient 1 | Patient 2 | Patient 3 | ||
|---|---|---|---|---|
| Demographic and sociobehavioural characteristics | ||||
| Age (years)/sex | 26/M | 54/M | 38/M | |
| Recent travel/past history of pulmonary TB | No/no | No/yes | No/no | |
| Social behaviours/addiction | Smoke tobacco and electronic cigarettes, drink alcohol and use illicit drugs | PWID | - | |
| HIV status | HIV status/CDC stage | Positive/C3 | Positive/C3 | Negative |
| HIV transmission | Heterosexual | Injection drug use | - | |
| CD4 cell counts (/mm3) | 14/mm3 | 600/mm3 | - | |
| CD4 nadir (/mm3) | 14/mm3 | 1/mm3 | - | |
| Viral load (cells/mL) | 130,000 | <50 | - | |
| HIV regimen (ART) | EFV/TDF/FTC | 3TC/AZT/LPVr | - | |
| Clinical characteristics, and laboratory and imaging findings | ||||
| Clinical presentation | Fever, fatigue haemoptysis, cough and polypnoea | Fever, fatigue, weight loss, haemoptysis and chest pain | Fever, weight loss, diarrhoea and abdominal pain | |
| Duration of symptoms (days) | 30 | 55 | 90 | |
| Laboratory data (on admission) | White cell count/mm3 (4000–10,000/mm3) | 12400 | 7510 | 17800 |
| Lymphocytes/mm3 (1500–4000/mm3) | 310 | 940 | 510 | |
| Haemoglobin, g/dL (13.5–17.5 g/dL) | 10.8 | 11.6 | 12 | |
| Alanine aminotransferase, U/L (8–45 U/L) | 21 | 13 | 145 | |
| Aspartate aminotransferase, U/L (10–40 U/L) | 34 | 38 | 178 | |
| C-reactive protein, mg/L (<5 mg/L) | 210 | 93 | 178 | |
| ABG (on admission) | pH | 7.3 | 7.39 | - |
| PaO2/PaCO2 (mmHg) | 49/33.7 | 93/38.9 | - | |
| SaO2 (%) | 91 | 97 | - | |
| Tuberculin skin test (Mantoux) | Negative (4 mm) | Negative | Positive (18 mm) | |
| QuantiFERON-TB Gold | ND | ND | ND | |
| AFB direct examination (specimen) | Negative (sputum/BAL) | Negative (sputum/BAL) | Positive (sputum) | |
| Mycobacterium tuberculosis culturea (specimen) | Positive (BAL) | Positive (BAL) | Positive (sputum) | |
| Negative culture (under treatment)/delay (weeks) | Yes (3) | Yes (3) | Yes (4) | |
| Histological examination | - | - | Granulomas with (+) Ziehl–Neelsen staining | |
| Radiologic data (imaging features) | Thoracic CT showing right mediastinal mass | Thoracic CT showing right lower lobe mass | Thoracic and abdominal CT showing left upper lobe mass with enlarged lymph nodes and spleen | |
3TC, lamivudine; ABG, arterial blood gases; AFB, acid-fast bacilli; ART, antiretroviral therapy; AZT, zidovudine; BAL, bronchoalveolar lavage; CDC, Centers for Disease Control and Prevention; CT, computed tomography; EFV, efavirenz; FTC, emtricitabine; HIV, human immunodeficiency virus; LPVr, lopinavir/ritonavir; ND, not determined; PWID, people/person who injected drugs; TB, tuberculosis; TDF, tenofovir disoproxil fumarate.
a
Lowenstein–Jensen glycerated egg-based medium was used as the gold standard medium for M. tuberculosis culture.