Subsequent Antituberculous Treatment May Not Be Mandatory Among Surgically Resected Culture-Negative Pulmonary Granulomas: A Retrospective Nationwide Multicenter Cohort Study

doi:10.1093/ofid/ofab565

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23800

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23800

Title:	Subsequent Antituberculous Treatment May Not Be Mandatory Among Surgically Resected Culture-Negative Pulmonary Granulomas: A Retrospective Nationwide Multicenter Cohort Study
Authors:	Chung, CL;Huang, WC;Huang, HL;Chin, CS;Cheng, MH;Lee, MR;Lin, SH;Wang, JY;Lin, CH;Chong, IW;Shih, JY;Yu, CJ
Keywords:	acid-fast stain;caseous necrosis;granulomatous inflammation;pulmonary nodule;tuberculosis
Date:	2021
Issue Date:	2022-08-05T09:43:05Z (UTC)
Publisher:	OXFORD UNIV PRESS INC
ISSN:	2328-8957
Abstract:	Background. Histologic diagnosis of granuloma is often considered clinically equivalent to a definite diagnosis of pulmonary tuberculosis (TB) in endemic areas. Optimal management of surgically resected granulomatous inflammation in lung with negative mycobacterial culture results, however, remains unclear. Methods. From 7 medical institutions in northern, middle, and southern Taiwan between January 2010 and December 2018, patients whose surgically resected pulmonary nodule(s) had histological features suggestive of TB but negative microbiological study results and who received no subsequent anti-TB treatment were identified retrospectively. All patients were followed up for 2 years until death or active TB disease was diagnosed. Results. A total of 116 patients were enrolled during the study period. Among them, 61 patients (52.6%) were clinically asymptomatic, and 36 (31.0%) patients were immunocompromised. Solitary pulmonary nodule accounted for 44 (39.6%) of all cases. The lung nodules were removed by wedge resection in 95 (81.9%), lobectomy in 17 (14.7%), and segmentectomy in 4 (3.4%) patients. The most common histological feature was granulomatous inflammation (n = 116 [100%]), followed by caseous necrosis (n = 39 [33.6%]). During follow-up (218.4 patient-years), none of the patients developed active TB. Conclusions. In patients with surgically resected culture-negative pulmonary granulomas, the incidence rate of subsequent active TB is low. Watchful monitoring along with regular clinical, radiological, and microbiological follow-up, instead of routine anti-TB treatment, may also be a reasonable option.
URI:	http://dx.doi.org/10.1093/ofid/ofab565 https://www.webofscience.com/wos/woscc/full-record/WOS:000744962900041 https://ir.csmu.edu.tw:8080/handle/310902500/23800
Relation:	OPEN FORUM INFECTIOUS DISEASES ,2021,v8,issue 12
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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