A 38-year-old sandblasting worker presents with progressive exertional dyspnoea and bilateral upper-lobe eggshell calcification on chest X-ray. His condition is complicated by concomitant tuberculosis. The condition associated with highest risk of concomitant tuberculosis among the pneumoconioses is:
- A Coal workers' pneumoconiosis
- B Silicosis ✓
- C Asbestosis
- D Byssinosis
Explanation
Silicosis is uniquely associated with a markedly elevated risk of pulmonary tuberculosis (silicotuberculosis); silica particles impair macrophage function by preventing phagolysosomal fusion, reducing killing of Mycobacterium tuberculosis. The relative risk of TB in silica-exposed workers is 3–4 times higher than controls, and up to 20% of silicosis patients may develop silicotuberculosis. 'Eggshell calcification' of hilar lymph nodes is a classic radiological finding in silicosis. Coal workers' pneumoconiosis has a lower TB association; asbestosis is more associated with lung cancer and mesothelioma; byssinosis does not involve fibrosis or TB risk.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.