Submillisievert Computed Tomography of the Chest in Contact Investigation for Drug-Resistant Tuberculosis

J Korean Med Sci. 2017 Nov;32(11):1779-1783. doi: 10.3346/jkms.2017.32.11.1779.

Abstract

Close contacts with infectious tuberculosis (TB) are persons at high risk for developing active disease. We preliminarily introduced submillisievert chest computed tomography (CT) scan (effective dose, 0.19-0.25 millisievert) in a contact investigation of multi-drug resistant (MDR)-TB. Baseline CT scan showed minimal nodules or branching opacities in two of six contacts. A two-month follow-up examination revealed a radiologic progression in contact 1, subsequently having the microbiologic diagnosis of MDR-TB at an asymptomatic early stage, whereas nodules transiently increased after 3 months in contact 2, followed by a decrease after one year. Contact 1 was cured after 1.5-year of anti-MDR-TB treatment. In conclusion, early identification of secondary MDR-TB is feasible with submillisievert chest CT scans in contact investigations of MDR-TB, minimizing of MDR-TB transmission and offering a favorable treatment outcome. This was a clinical trial study and was registered at www.ClinicalTrials.gov (Identifier: NCT02454738).

Keywords: Computed Tomography; Drug-resistance; Tuberculosis.

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Male
  • Thorax / diagnostic imaging*
  • Tomography, X-Ray Computed*
  • Tuberculin Test
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / transmission*
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / drug therapy

Substances

  • Antitubercular Agents

Associated data

  • ClinicalTrials.gov/NCT02454738
  • ClinicalTrials.gov/NCT02454738