Objective To analyze the CT imaging features and pathological characteristics of adult pulmonary tuberculosis(TB)complicated by other pulmonary infections.Methods A total of 196 patients diagnosed with pulmonary TB at Anhui Chest Hospital from January 2021 to July 2023 were included in this study.Among them,98 patients with concurrent pulmonary infections formed the infection group,and 98 patients without pulmonary infections formed the non-infection group.Clinical data were organized to summarize the clinical features and CT imaging presentations of patients with coexisting pulmonary infections.Sputum or bronchial lavage fluid samples were collected for bacterial isolation using the streak plate method,and drug susceptibility testing was performed to analyze resistance patterns.Results The primary clinical symptoms were coughing and expectoration.The infection group showed higher rates of hypoalbuminemia,productive cough,wheezing,and pulmonary rales compared to the non-infection group(P＜0.05).Elevated levels of white blood cells,neutrophils,and C-reactive protein were observed in the infection group(P＜0.05).Lesions predominantly appeared in the apical posterior segments of the upper lobes and the dorsal segments of the lower lobes.CT images typically showed nodular shadows and patchy opacities.The infection group had more widespread involvement across multiple pulmonary segments and lobes,bilateral lungs,and a higher incidence of consolidation compared to the non-infection group(P＜0.05).Enlarged mediastinal lymph nodes and pleural effusion were less common in the infection group(P＜0.05).The predominant pathogens in patients with pulmonary TB complicated by infections were Gram-negative bacteria(88.78%),including Klebsiella pneumoniae,Pseudomonas aeruginosa,and Escherichia coli,with most exhibiting drug resistance.Conclusion Adults with pulmonary TB complicated by other pulmonary infections lack specific clinical presentations but have broader lesion distribution,complex pathogen profiles,and severe drug resistance.An exacerbation of symptoms should prompt enhanced assessment and improved management of pulmonary infections.
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