Cumulative percentage of patients who developed chronic pulmonary aspergillosis after initiating treatment for NTM-LD.

<p>Cumulative percentage of patients who developed chronic pulmonary aspergillosis after initiating treatment for NTM-LD.</p

Univariate and multivariable analyses of risk factors for development of CPA.

<p>Univariate and multivariable analyses of risk factors for development of CPA.</p

Development of chronic pulmonary aspergillosis in a patient with NTM-LD.

<p>Chest computed tomography images are shown for a 69-year-old female patient with <i>Mycobacterium intracellulare</i> lung disease. (A) At the time of initiation of antibiotic therapy for <i>M</i>. <i>intracellulare</i> lung disease, there was a large cavitary consolidation in the right upper lobe. Serum <i>Aspergillus</i> precipitin antibody was negative. (B) After 12 months of antibiotic therapy for <i>M</i>. <i>intracellulare</i> lung disease, cavitary consolidation in the right upper lobe was improved, and sputum cultures for NTM were negative. (C) After 18 months of antibiotic therapy for <i>M</i>. <i>intracellulare</i> lung disease, the patient’s respiratory symptoms and the consolidation in the right upper lobe were aggravated. Sputum cultures for NTM were negative. However, serum <i>Aspergillus</i> precipitin antibody was strongly positive, and chronic pulmonary aspergillosis was diagnosed.</p

Survival curves in study patient groups using Kaplan-Meier analysis.

<p>Survival curves in study patient groups using Kaplan-Meier analysis.</p

Clinical and Laboratory Differences between Lymphocyte- and Neutrophil-Predominant Pleural Tuberculosis

<div><p>Pleural tuberculosis (TB), a form of extrapulmonary TB, can be difficult to diagnose. High numbers of lymphocytes in pleural fluid have been considered part of the diagnostic criteria for pleural TB; however, in many cases, neutrophils rather than lymphocytes are the predominant cell type in pleural effusions, making diagnosis more complicated. Additionally, there is limited information on the clinical and laboratory characteristics of neutrophil-predominant pleural effusions caused by <i>Mycobacterium tuberculosis</i> (MTB). To investigate clinical and laboratory differences between lymphocyte- and neutrophil-predominant pleural TB, we retrospectively analyzed 200 patients with the two types of pleural TB. Of these patients, 9.5% had neutrophil-predominant pleural TB. Patients with lymphocyte-predominant and neutrophil-predominant pleural TB showed similar clinical signs and symptoms. However, neutrophil-predominant pleural TB was associated with significantly higher inflammatory serum markers, such as white blood cell count (<i>P</i> = 0.001) and C-reactive protein (<i>P</i> = 0.001). Moreover, MTB was more frequently detected in the pleural fluid from patients in the neutrophil-predominant group than the lymphocyte-predominant group, with the former group exhibiting significantly higher rates of positive results for acid-fast bacilli in sputum (36.8 versus 9.4%, <i>P</i> = 0.003), diagnostic yield of MTB culture (78.9% versus 22.7%, <i>P</i> < 0.001) and MTB detected by polymerase chain reaction (31.6% versus 5.0%, <i>P</i> = 0.001). Four of seven patients with repeated pleural fluid analyses revealed persistent neutrophil-predominant features, which does not support the traditional viewpoint that neutrophil-predominant pleural TB is a temporary form that rapidly develops into lymphocyte-predominant pleural TB. In conclusion, neutrophil-predominant pleural TB showed a more intense inflammatory response and a higher positive rate in microbiological testing compared to lymphocyte-predominant pleural TB. Pleural TB should be considered in neutrophil-predominant pleural effusions, and microbiological tests are warranted.</p></div

Baseline Characteristics of 200 Patients with Pleural TB.

<p>Baseline Characteristics of 200 Patients with Pleural TB.</p

Groupings of study population according to diagnostic criteria and cell type predominance.

<p>TB, tuberculosis; AFB, acid-fast bacilli; PCR, polymerase chain reaction; MTB, <i>Mycobacterium tuberculosis</i>; ADA, adenosine deaminase.</p

Consecutive Pleural Fluid Analysis of Patients with Neutrophil-Predominant Pleural TB.

<p>Consecutive Pleural Fluid Analysis of Patients with Neutrophil-Predominant Pleural TB.</p

Pleural Fluid Analysis of Lymphocyte- and Neutrophil-Predominant Pleural TB.

<p>Pleural Fluid Analysis of Lymphocyte- and Neutrophil-Predominant Pleural TB.</p

Microbiological Characteristics of Lymphocyte- and Neutrophil-Predominant Pleural TB.

<p>Microbiological Characteristics of Lymphocyte- and Neutrophil-Predominant Pleural TB.</p