Recognizing Early-Stage TB

Recognizing Early-Stage TB

Tuberculosis is a leading cause of global mortality, responsible for around 1.6 million deaths each year. Some people who test negative based on sputum testing still have active pulmonary tuberculosis (PTB); diagnosing and treating them is vital for preventing the development of disease that can spread. Moreover, sputum culture-negative PTB is an early stage of the disease that can be treated with fewer drugs for a shorter time than sputum-culture positive PTB. To gauge the frequency of culture-negative PTB among adult PTB patients, Jacqueline Achkar, M.D., M.Sc., and colleagues analyzed data reported to the New York City Department of Health from 2011 through 2013 on 796 patients with active PTB. A significant number of patients—116, or 15 percent—were culture-negative. Compared with people with culture-positive PTB, culture-negative individuals tended to have fewer symptoms such as coughing and weight loss and had fewer abnormalities on radiographic imaging. Awareness of these findings could improve the detection and treatment of this early-disease state and reduce PTB transmission. Dr. Achkar is associate professor of medicine and of microbiology & immunology. The first author of the study, which published online on February 8 in JAMA Network Open, is Minh-Vu H. Nguyen, M.D., M.Sc., who was an Einstein medical student and a scholar of Einstein’s Master of Science Clinical Research Training Program (CRTP).