Marciniuk DD, McNab BD, Martin WT, et al [ Univ of Saskatchewan, Saskatoon, Canada]
Detection of Pulmonary Tuberculosis in patients with a Normal Chest Radiograph
Chest 115: 445-452, 1999
Pulmonary tuberculosis [TB] in the presence of a normal chest radiograph [CXR] has been reported.
Patients were identified because they had 1 or more symptoms: cough for more than 1 month, fever for more than 1 week, or skin-test conversion after contact with infectious TB.
The rate of culture-positive TB associated with normal CXR was less than 1% and steadily rose to 10%.
It is recommended that patients seen with a cough that has persisted for more than 1 month, with a fever for more than 1 week duration, or with documented skin-test conversion less than 2 years after known exposure to infectious TB should submit sputum for a mycobacterium tuberculosis smear and culture, even in the presence of a normal CXR.