Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis—A Systematic Review

Francesco Di Gennaro, Luigi Pisani, Nicola Veronese, Damiano Pizzol, Valeria Lippolis, Annalisa Saracino, Laura Monno, Michaëla A.M. Huson, Roberto Copetti, Giovanni Putoto and Marcus J. Schultz
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Francesco Di Gennaro: Department of Infectious Diseases, University of Bari “Aldo Moro”, 70121 Bari, Italy
Luigi Pisani: Mahidol Oxford Tropical Medicine Research Unit, Bangkok 10400, Thailand
Nicola Veronese: Department of Medicine (DIMED)-Geriatrics Section; University of Padova, 35128 Padova, Italy
Damiano Pizzol: Doctors with Africa, Research Unit Beira, Beira 1316, Mozambique
Valeria Lippolis: Department of Intensive Care; Academic Medical Center, 1005 AZ Amsterdam, The Netherlands
Annalisa Saracino: Department of Infectious Diseases, University of Bari “Aldo Moro”, 70121 Bari, Italy
Laura Monno: Department of Infectious Diseases, University of Bari “Aldo Moro”, 70121 Bari, Italy
Michaëla A.M. Huson: Department of Internal Medicine, Academic Medical Center, 1011 Amsterdam, The Netherlands
Roberto Copetti: Department of Emergency Medicine; Latisana Hospital, 33053 Latisana, Italy
Giovanni Putoto: Doctors with Africa, 35128 Padova, Italy
Marcus J. Schultz: Mahidol Oxford Tropical Medicine Research Unit, Bangkok 10400, Thailand

IJERPH, 2018, vol. 15, issue 10, 1-9

Abstract: Background : Chest ultrasound (CUS) has been shown to be a sensitive and specific imaging modality for pneumothorax, pneumonia, and pleural effusions. However, the role of chest ultrasound in the diagnosis of thoracic tuberculosis (TB) is uncertain. We performed a systematic search in the medical literature to better define the potential role and value of chest ultrasound in diagnosing thoracic tuberculosis. Aim : To describe existing literature with regard to the diagnostic value of chest ultrasound in thoracic tuberculosis. Methods : MEDLINE, EMBASE, and Scopus databases were searched for relevant articles. We included studies that used chest ultrasound for the diagnosis or management of any form of thoracic tuberculosis, including pulmonary, pleural, mediastinal, and military forms. Results : We identified five main fields of chest ultrasound application: (1) Detection, characterization, and quantification of TB; (2) detection of residual pleural thickening after evacuation; (3) chest ultrasound-guided needle biopsy; (4) identification of pathologic mediastinal lymph nodes in children; and (5) identification of parenchymal ultrasound patterns. Effusion was also detected, in early stages, with signs of organization in 24–100% of patients. A low to moderate (10–23%), false negative rate was reported for chest ultrasound-guided needle biopsy. CUS was able to identify mediastinal lymph nodes in as many as 67% of patients with negative chest radiography. Conclusions : Very few studies with important methodological limitations analyze the role of chest ultrasound in the diagnosis of TB. The scarce available data suggests potential targets of future diagnostic or feasibility trials, such as the detection of tuberculosis–related pleural effusion, residual pleural thickening, lymphadenopathy, TB parenchymal patterns, or the use of CUS in biopsy guidance.

Keywords: tuberculosis; lung ultrasound; low-resource settings (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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