Revisiting Asymptomatic Pulmonary Tuberculosis with Cavitary Lesion Detected During Routine Chest Radiography in a Healthcare Worker: A Case in Point

Abstract

This report describes a 39-year-old female clinical nurse working in an intensive care unit diagnosed with bacteriologically confirmed subclinical pulmonary TB after an abnormal chest radiograph was detected during a routine annual health examination at her hospital. The chest radiograph demonstrated reticulonodular opacities in the right upper lung zone. Correspondingly, subsequent chest computed tomography revealed a cavitary lesion with surrounding centrilobular nodules with a tree-in-bud pattern involving the apical and posterior segments of the right upper lobe, despite the absence of TB-related symptoms. Sputum microbiology later confirmed Mycobacterium tuberculosis. This case in point provides some interesting learning points and highlights the importance of recognising subclinical TB and the potential role of routine chest radiography screening in detecting otherwise unrecognised disease in high-risk populations such as healthcare workers.