A total of 302 Chinese patients were diagnosed on clinical and radiographic grounds by
chest physicians from the Hong Kong Chest Service as having radiographically active
pulmonary tuberculosis, but had sputum negative for acid-fast bacilli on 5 recent
microscopical examinations. They were not given antituberculosis chemotherapy until
active disease had been confirmed by positive bacteriological findings, or by radiographic
or clinical deterioration during close observation. Of the 283 patients assessed
up to 30 months, 200 (71 %) had active disease confirmed and had chemotherapy
started during the 30 months. A further 42 (15 %) had evidence of changing lesions on
serial chest radiography, and hence of recently active disease.
A number of characteristics of the patients and of their bacteriological and radiographic
status were tested singly and in combination for association with the presence
of active disease confirmed on admission or at any time during the 30 months. Patients
with radiographic lesions which were larger and classified as “active” on independent
radiological assessment, and with a history of blood-streaked sputum or frank
haemoptysis were more likely to have unquestionably active disease on admission or
at some time during the 30 months, than patients without these characteristics