Post-mortem pulmonary tuberculosis: comparison of available diagnostic methods
https://doi.org/10.47665/tb.40.2.006
- Author:
Chainchel Singh, M.K.
1
,
2
;
Johari, B.
2
;
Naik, V.R.
3
;
Lai, P.S.
4
;
Siew, S.F.
4
Author Information
1. Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM) Sg Buloh, Jalan Hospital, 47000 Selangor, Malaysia&
2. Department of Radiology, Faculty of Medicine, Universiti Teknologi MARA (UiTM) Sg. Buloh, Jalan Hospital, 47000 Selangor, Malaysia
3. Department of Pathology, Perdana University Wisma Chase Perdana, Changkat Semantan, Damansara Heights, 50490 Kuala Lumpur, Malaysia
4. National Institute of Forensic Medicine (IPFN), Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Pahang, 50586 Wilayah Persekutuan Kuala Lumpur, Malaysia
- Publication Type:Journal Article
- Keywords:
Autopsy;
pulmonary tuberculosis;
post-mortem computed tomography;
bacteriology culture;
health workers
- From:Tropical Biomedicine
2023;40(No.2):165-169
- CountryMalaysia
- Language:English
-
Abstract:
Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a serious public health threat with
the World Health Organisation (WHO) reporting 5.8 million cases and 1.3 million deaths in the year
2020 due to TB. TB can be diagnosed by imaging, histopathological and bacteriological methods with
culture remaining the gold standard. This study was performed to look at the sensitivity and specificity
of post-mortem computed tomography (PMCT) imaging when compared to culture in diagnosing
pulmonary tuberculosis. This was a retrospective comparative study looking at post mortem cases
where lung tissue samples sent for TB culture at Hospital Kuala Lumpur were compared against PMCT
imaging. Exclusion criteria included contaminated samples, decomposed cases, immunocompromised
subjects and those below 18 years of age. Subjects included 80 medico-legal autopsy cases at the
National Institute of Forensic Medicine, Hospital Kuala Lumpur, Malaysia who had whole body PMCT
done in accordance with the Institute’s protocol and tissue samples sent for bacteriology culture for
tuberculosis. PMCT findings were positively associated with acid-fast organisms in 23.5 out of 33 cases
(71.2%). Our study also showed that PMCT had a sensitivity of 71.3% and specificity of 54.3% (95% CI:
39.5–68.4) in diagnosing TB based on the protocol set in this study. This study showed that there was
relatively good agreement between radiological PMCT findings and bacterial culture, suggesting that
radiological examination is a relatively reliable tool for preliminary screening and possible diagnosis of
TB prior to a postmortem examination which would be beneficial in reducing the risk of transmission
of TB to health workers during autopsy.
- Full text:8.2023my1402.pdf
