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Chest Infections |

Unilateral Posttuberculosis Destroyed Lung: A Preventable but Fatal Lung Disease

Ademola Fawibe*, MBBS; Philip Kolo, MBBS; J. Ogunmodede, MBBS; O. Desalu, MBBS; Kazeem Salami, MBBS
Author and Funding Information

University of Ilorin, Ilorin, Nigeria


Chest. 2012;142(4_MeetingAbstracts):208A. doi:10.1378/chest.1389543
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Abstract

SESSION TYPE: Respiratory Infections Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Despite being a curable disease, TB may be complicated by fatal complications. Unilateral post-TB destroyed lung is a serious disabling condition associated with high mortality. We designed this study to assess the outcome of unilateral post-TB destroyed lung among patients with PTB.

METHODS: it was a cohort study in which we enrolled patients with unilateral post-TB destroyed lung referred to our clinic from January to December 2010. We recorded demographic, radiological, resting ECG and resting echocardiographic findings(including estimated mean PAP)at presentation. They were followed up monthly from presentation till death/lost to follow up or if alive till December 2011.

RESULTS: Of the 21 patients enrolled, data from 18(85.7%) were analysed(3 were excluded: 2 lost to follow up and 1 still sputum AAFB positive). Most were HIV negative males(13, 72.2%)who had received TB treatment more than once due to previous default, with left lung destruction in 12(66.7%), mean age 41.5 ± 14.4 years and 9(50.0%)deaths. Those who died were younger (mean age 34.8 ± 10.6 vs 48.2 ± 15.1 years, p= 0.043), had higher estimated mean PAP(48.6 ± 4.3 vs 28.4 ± 10.1 mmHg, p<0.0001)and shorter mean duration of follow up(6.1 ± 1.8 vs 14.1 ± 2.5 months, p<0.0001)than survivors. The most significant predictors of outcome were mean PAP and mean duration of follow up with spearman’s rho 0.847 and - 0.871 respectively, P<0.0001.

CONCLUSIONS: our study suggests that PTB complicated by unilateral lung destruction is associated with fatal pulmonary hypertension. Additionally, it showed that this complication was commoner in those who defaulted during earlier treatment.

CLINICAL IMPLICATIONS: Prompt diagnosis and strict adherence to the standard treatment should be encouraged to prevent this fatal complication.

DISCLOSURE: The following authors have nothing to disclose: Ademola Fawibe, Philip Kolo, J. Ogunmodede, O. Desalu, Kazeem Salami

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University of Ilorin, Ilorin, Nigeria

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