Pulmonary tuberculosis – Still a challenging diagnosis

Background: Pulmonary tuberculosis (TB) is a chronic disease, with slow evolution and slow recovery with specific treatment. Some of the cases have differential diagnosis doubt over a long period of time. Material and methods: We present a series of 6 patients (5 females), mean age 43.1 years (range 27-70 years), with various respiratory symptoms and opacities on chest radiography, who needed multiple diagnosis procedures over a long period of time before the diagnosis of TB. Results: Mean delay of diagnosis was 19.1 month (range 5-24 months). Symptoms consist of: cough (6), dyspnea (4), and low grade fever (2). Chest X-ray showed: pulmonary micronodular pattern (4), consolidation (1), and pseudotumor (1). CT-scan showed “tree in bud” pattern in patients with micronodules on chest radiography. One patient monitored several times with CT-scan and bronchoalveolar lavage was diagnosed with TB after 2 years, when cavities appeared on CT-scan and sputum smear became positive for acid fas...