Abstract
The discovery of anti- tuberculosis (TB) drugs, in the middle of last century, did not resolve the goal of a better healing, and the most important cause is represented by delayed diagnosis of TB disease. We conducted a single-center case control study, from January, 1st, 2017 to December, 31st, 2024, including 400 adult symptomatic inpatients diagnosed with post TB lung disease (PTLD), after a previous episode of treated TB disease. There were excluded 168 patients without pulmonary function testing (PFT), those with significant occupational exposure, and/or diseases autoimmune, COVID-19 or HIV infection, which might interfere lung function assessment. All demographics, behavioral and baseline PTB characteristics (relapses, clinical, imagistic, endoscopic, microbiologic, PFT, evolution) were assessed in order to inventorying sequelae and lung damage, types of lung function impairment. Eligible patients (n=232), mean aged 60.94+/-11.895 years, males (55.17%), were divided into 129 cases with previous bacteriologically confirmed PTB (mean age 58.37+/-11.86 years; 55.81% males) and 103 controls with previous clinically diagnosed PTB (mean age 60.04+/-11.222; 54.37% males). Delayed diagnosis and relapses of PTB had greater impact on PTLD development in cases (p=0.000), as well as previous cavitary PTB (p=0.000). The risk of death, during hospitalization, was greater in cases (p=0.000). Spectrum of PTLD, in cases, was dominated by bronchiectasis (p=0.000), suppurative episodes (p=0.004), open healing cavitation (p=0.000), intracavitary aspergilloma (p=0.002), fibrothorax (p=0.000), lung function impairment (p=0.030). In conclusion, PTLD severity is related to delayed diagnosis of previous contagious PTB, permanent lung damage, impairment of lung function, having a higher risk of death.