Abstract: Poster Presentations |


Raquel Nahra, MD*; Sergio L. Zanotti-Cavazzoni, MD; Anand Kumar, MD
Author and Funding Information

Cooper University Hospital, Camden, NJ


Chest. 2005;128(4_MeetingAbstracts):380S. doi:10.1378/chest.128.4_MeetingAbstracts.380S
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PURPOSE:  To describe a group of patients with septic shock caused by M. Tuberculosis and compare their outcomes to those of patients with septic shock caused by other microorganisms.

METHODS:  Data was extracted from a multicenter database with information from the records of 2731 patients with septic shock. Patients with septic shock caused by M. Tuberculosis were identified by positive blood or multi-site cultures.

RESULTS:  A total of 2731 patients with septic shock were studied. Eleven patients (0.4%) had septic shock caused by M.Tuberculosis (MTB group). In the MTB group, the mean age was 44.2 (±19.5) years, mean APACHE II score was 26 (±8), 36% were males and 64% were females. Comorbid conditions included; alcohol use 54%, non-HIV immunosupresive diseases 36.4%, and diabetes mellitus 18.2%. None of these patients had documented HIV. Overall mortality in the MTB group was 81.8 %, and mean length of stay in the ICU was 12.7(± 17.1) days. Inapropriate initial antimicrobial coverage based on culture results was given to five patients (45.5%) in the MTB group. When compared to patients with septic shock caused by other microorganism (OTH group), patients in MTB group were younger (44.27(±19.5) years vs 62.66 (±16.4)) years p = 0.0002), and more likely to have alcohol use as a comorbidity (54.4% vs 13.8 %, p= 0.0013). Patients in the MTB group were more likely to receive inappropriate initial antimicrobial therapy than patients in the OTH group (45.5% vs 18.6%, p=0.0039). Patients in the MTB group had a higher mean ICU LOS (12.21 days vs 8.1 days ), had a higher overall mortality (81.8% vs 56.2% , p = 0.12 ), and were more likely to develop hepatic failure (p 0.0039).

CONCLUSION:  M. Tuberculosis is an uncommon cause of septic shock. However, when it occurs it is associated with increased morbidity and mortality and a significant delay in institution of appropriate antituberculous treatment.

CLINICAL IMPLICATIONS:  Mycobacterium Tuberculosis should be thought of as a possible cause for septic shock in apropriate clinical situations.

DISCLOSURE:  Raquel Nahra, None.

12:30 PM - 2:00 PM




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