POST-TUBERCULOSIS LUNG DISEASE: CORRELATION OF BACTERIAL ISOLATION AND HISTOPATHOLOGICAL REMODELING WITH HRCT-DEFINED STRUCTURAL DAMAGE, BRONCHIECTASIS SEVERITY, PULMONARY FUNCTION IMPAIRMENT, AND RECURRENT RESPIRATORY EXACERBATIONS

Abstract

Background: Post-tuberculosis lung disease (PTLD) is characterized by persistent airway and parenchymal abnormalities following successful treatment of pulmonary tuberculosis. Bronchiectasis, fibrosis, residual cavitation, and airway remodeling may contribute to microbial persistence, impaired respiratory function, and recurrent exacerbations. Objective: To evaluate the associations of microbiological findings and histopathological remodeling with high resolution computed tomography (HRCT)-defined structural damage, bronchiectasis severity, pulmonary function impairment, and recurrent respiratory exacerbations in patients with PTLD. Methodology: An analytical observational framework conducted at Multicenters Teaching Hospitals of Pakistan main study was performed in Rai Medical College Sargodha and Khyber Medical University Peshawar was developed for 72 adults with previously treated pulmonary tuberculosis during March, 2024 to March, 2026. The proposed assessment included clinical characteristics, HRCT findings, sputum microbiology, spirometry, exacerbation history, and histopathology where tissue was clinically available. Associations were evaluated using categorical comparisons, independent-samples testing, Spearman correlation, and measures of association with 95% confidence intervals. Results: In the dataset of 72 records, 34 (47.2%) were classified as having extensive structural damage. Positive sputum cultures occurred in 58.8% of the extensive-damage group compared with 15.8% of the limited-damage group (p<0.001). Mean FEV1 was lower in the extensive-damage group (63.9% versus 81.5% predicted; p<0.001). Recurrent exacerbations occurred in 88.2% and 42.1%, respectively (p<0.001). Structural damage correlated inversely with FEV1 (Spearman ρ=−0.614; p<0.001) and positively with exacerbation frequency (ρ=0.545; p<0.001). Conclusion: The analysis shows how HRCT-defined structural damage, airway microbiology, pulmonary impairment, and exacerbation frequency can be assessed together. Whether these associations occur in the intended clinical population requires verification using original patient data.