Bronchial anthracosis: a potent clue for diagnosis of pulmonary tuberculosis.
Bronchial anthracosis: a potent clue for diagnosis of pulmonary tuberculosis.
复制标题
DOI：
10.5001/omj.2011.05
复制
发表时间：
2011-01-01
影响因子：
--
通讯作者：
Pirnazar, Omidreza
中科院分区：
文献类型：
--
作者：
Ghanei, Mostafa;Aslani, Jafar;Pirnazar, Omidreza
提示：职业性暴露于碳、二氧化硅和石英颗粒是支气管炭疽病的易感因素。在某些情况下，炭疽病可能与结核分枝杆菌有关。本研究旨在探讨支气管炭疽病患者的临床、影像学和细菌学表现及其与结核病的关系。共919例患者接受了肺部疾病的诊断性支气管镜检查。其中，71例患者显示支气管炭疽病的证据，32例（45.8%）男性和39例（54.2%）女性，年龄范围，30-92岁。前瞻性地分析和总结了其独特的临床特征、支气管镜病变的性质和放射学表现。细菌学研究和实验室检查结果进行了评估。结果：41例（57.8%）患者结核分枝杆菌涂片或培养阳性。在71例有支气管镜检查肺部疾病证据的患者中，30例既往有职业暴露，41例既往无暴露。肺结核患者胸部X线空洞性病变、纯化蛋白衍生物试验阳性及血沉升高的发生率明显高于其他肺结核患者。对于有这种支气管镜检查结果的患者，应进行详细的检查，以防止结核病的传播，并避免不必要的侵入性操作。
OBJECTIVES: Occupational exposure to carbon, silica, and quartz particles are predisposing factors for bronchial anthracosis. In some cases anthracosis may be associated with mycobacterium tuberculosis. This study aims to investigate the clinical, radiographic, and bacteriologic findings in bronchial anthracosis patients and its association with tuberculosis.METHODS: This is a prospective study conducted between 1998 and 2001. A total of 919 patients underwent diagnostic bronchoscopy for pulmonary diseases. Of these, 71 patients showed evidence of bronchial anthracosis, 32 (45.8%) males and 39 (54.2%) females, age range, 30-92 years. The distinctive clinical features, nature of bronchoscopic lesions, and radiologic findings were analyzed prospectively and summarized. Bacteriologic studies and results of laboratory examinations were also assessed.RESULTS: Forty-one (57.8%) patients had positive smears or cultures for mycobacterium tuberculosis. Of 71 patients with bronchoscopic evidence of pulmonary diseases, 30 had previous occupational exposure, and 41 stated no previous exposure. Cavitary lesions on chest radiography, positive purified protein derivative tests and high ESR were more prevalent in tuberculous patients than the others.CONCLUSION: Bronchial anthracosis was caused by active or previous tuberculous infection. Detailed examinations for the presence of active tuberculosis should be performed in patients with such bronchoscopic findings in order to prevent the spread of tuberculosis and to avoid unnecessary invasive procedures.