PURPOSE: Tuberculosis (TB) is a serious health problem worldwide. This study’s purpose is to characterize the patient population admitted in an Infectious Diseases Ward with tuberculosis.
METHODS: Retrospective observational study including the patients admitted in an Infectious Diseases Ward with TB between January 2008 and December 2010. Data was obtained from file review.
RESULTS: There were 52 TB related admissions, with a total of 39 patients, since nine were admitted more than once. One case was excluded because an atypical mycobacterium was detected after discharge. Of the 38 patients with tuberculosis, three (7.9%) had no HIV1/2. The majority was men (73.7%) and average age was 42.6 years. The non-HIV patients were older (average 54.3 years) than the HIV patients (41.6 years). Length of stay was 25.5 days. Most patients (86.8%) presented disseminated TB with lung involvement, 19 had bilateral reticulonodular infiltrate on the chest X-ray and the remaining had several different patterns. Mycobacterium tuberculosis was identified in 27 patients (71.1%), most in samples from different tissues, using polymerase chain reaction, direct and cultural exams. Seven patients already had the agent isolated when the anti-tuberculous drugs were started. All other patients started first line empirical anti-tuberculous agents after collecting the samples for microbiological testing. There were two cases of streptomycin resistance and two of multi-drug resistance. According to the Centers for Disease Control AIDS Classification, thirty patients were class C3, two C2 and one C1. Two had HIV2. Nine patients died, two were transferred to Intensive Care Units, three to Isolation Units and six went to other hospitals. The others maintained follow-up in the Immunodeficiency Clinic.
CONCLUSIONS: Setting strategies to control TB depends on our comprehension of the challenges that it presents. In this series, as in the world’s population, most of the patients present TB and AIDS, with multisystem disease, being lung the most frequent organ involved.
CLINICAL IMPLICATIONS: It is crucial to have a high index of suspicion for the diagnosis and empirical therapy can be lifesaving.
DISCLOSURE: The following authors have nothing to disclose: Elisa Vedes, Alice Ribeiro, Francisco Antunes
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