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Volume 17, Number 3—March 2011

Dispatch

Distinguishing Tuberculosis from Nontuberculous Mycobacteria Lung Disease, Oregon, USA

Brian A. KendallComments to Author , Cara D. Varley, Dongseok Choi, P. Maureen Cassidy, Katrina Hedberg, Mary A. Ware, and Kevin L. Winthrop
Author affiliations: Author affiliations: University of Utah, Salt Lake City, Utah, USA (B.A. Kendall); Oregon Health and Science University, Portland, Oregon, USA (C.D. Varley, D. Choi, K.L. Winthrop); Oregon Public Health Division, Portland (P.M. Cassidy, K. Hedberg); Multnomah County Health Department, Portland (M.A. Ware)

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Table 1

Demographic, clinical, and radiographic features of TB patients compared with NTM patients, Oregon, USA, 2005–2006*

Characteristic No. (%) TB patients,
n = 80† No. (%) NTM patients, n = 127 Relative proportion (95% CI) p value
Demographics
Median age, y (range) 44 (5–86) 67 (12–92) 0.95 (0.93–0.96) <0.01‡
Male 49 (61) 48 (38) 1.6 (1.2–2.2) <0.01
Not US born§
65 (81)
15 (19)
4.0 (2.5–6.3)
<0.01‡
Clinical signs and symptoms
Cough 58 (73) 98 (77) 0.9 (0.8–1.1) 0.45
Hemoptysis 12 (15) 28 (22) 0.7 (0.4–1.3) 0.21
Constitutional symptoms¶
56 (70)
61 (48)
1.5 (1.2–1.8)
0.03‡
Chest radiograph
Bronchiectasis 2 (3) 6 (5) 0.5 (0.1–2.6) 0.71
Cavity 18 (23) 11 (9) 2.7 (1.3–5.3) <0.01
Effusion 10 (13) 8 (6) 2.1 (0.9–5.0) 0.10
Infiltrate 68 (87) 69 (54) 1.6 (1.3–1.9) <0.01‡
Lymphadenopathy
4 (5)
3 (2)
2.2 (0.5–9.4)
0.43
Concurrent conditions
Immunosuppressive medications# 8 (10) 34 (27) 0.4 (0.2–0.8) <0.01
COPD 2 (3) 29 (23) 0.1 (0.0–0.4) 0.19‡
Previous TB 3 (4) 13 (10) 0.4 (0.1–1.2) 0.11
Diabetes 10 (13) 8 (6) 2.0 (0.8–4.8) 0.12
Tobacco smoking (previous or current) 26 (33) 53 (42) 0.8 (0.5–1.1) 0.19
Lung cancer 4 (5) 8 (6) 0.8 (0.2–2.6) 0.77
HIV/AIDS 0 4 (3) 0.30

*TB, tuberculosis; NTM, nontuberculous mycobacteria; CI, confidence interval; COPD, chronic obstructive pulmonary disease.
†Two TB patients excluded because of missing clinical data, 4 from multivariate analysis (n = 78).
‡p value from multivariate analysis including COPD, age, not US born, constitutional symptoms, and infiltrate on radiograph.
§54 (26%) patients excluded because of missing country of origin.
¶Fever, night sweats, weight loss, or appetite loss.
#Systemic corticosteroids, inhaled corticosteroids, disease-modifying anti-rheumatic drugs, tissue necrosis factor-α inhibitors, cancer chemotherapy, and calcineurin inhibitors.

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