Reassessing the diagnosis of residual pulmonary tuberculosis cavities among healing TB patients.

Objective To elucidate the need of reassessing the diagnosis when residual pulmonary tuberculosis cavities still exist.Methods From Jan 2003 to Jun 2007,67 patients who were initially diagnosed with pulmonary tuberculosis and had already completed a short course treatment were enrolled.All the patients were negative for the sputum TB tests,but still had residual pulmonary cavities.Within three months after the short course treatment,these patients were re-evaluated by bronchoalveolar lavage(BAL).Fifty-nine of them were also re-evaluated by CT-guided percutaneous lung needle biopsy(PLB)after receiveing the informed consent from the patients.Results None of the sixty-seven patients was found TB positive by BAL.Among 59 of these patients who had CT-guided PLB,62 PLB specimens were collected:two specimens were positive for cancer,five for fungi and five for TB,three for bacteria.Conclusion Even when the diagnosis of pulmonary TB infection is confirmed and the anti-TB therapy is effective,the diagnosis of other diseases complicated with TB infection should still be considerd,especially when there are residual pulmonary tuberculosis cavities.To avoid delayed diagnosis of cancer or other infectious disease complicated in pulmonary TB patients,repeated evaluation by using PLB or BAL was encouraged.