原创力文档validation of a clinical-radiographic score to assess the probability of pulmonary tuberculosis in suspect patients with negative sputum smears验证clinical-radiographic得分的概率评估的肺结核患者在怀疑-痰涂片检查.pdfVIP
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validation of a clinical-radiographic score to assess the probability of pulmonary tuberculosis in suspect patients with negative sputum smears验证clinical-radiographic得分的概率评估的肺结核患者在怀疑-痰涂片检查
Validation of a Clinical-Radiographic Score to Assess the
Probability of Pulmonary Tuberculosis in Suspect
Patients with Negative Sputum Smears
1 2 ´ 3 1 2 2
Alonso Soto *, Lely Solari , Javier Dıaz , Alberto Mantilla , Francine Matthys , Patrick van der Stuyft
´
1 Department of Medicine, Hospital Nacional Hipolito Unanue, Lima, Peru, 2 Epidemiology and Disease Control Unit, Institute of Tropical Medicine, Antwerp, Belgium,
3 Department of Medicine, Hospital Nacional Cayetano Heredia, Lima, Peru
Abstract
Background: Clinical suspects of pulmonary tuberculosis in which the sputum smears are negative for acid fast bacilli
represent a diagnostic challenge in resource constrained settings. Our objective was to validate an existing clinical-
radiographic score that assessed the probability of smear-negative pulmonary tuberculosis (SNPT) in high incidence settings
in Peru.
Methodology/Principal Findings: We included in two referral hospitals in Lima patients with clinical suspicion of pulmonary
tuberculosis and two or more negative sputum smears. Using a published but not externally validated score, patients were
classified as having low, intermediate or high probability of pulmonary tuberculosis. The reference standard for the
diagnosis of tuberculosis was a positive sputum culture in at least one of 2 liquid (MGIT or Middlebrook 7H9) and 1 solid
(Ogawa) media. Prevalence of tuberculosis was calculated in each of the three probability groups. 684 patients were
included. 184 (2
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