Epidemiological, Clinical, Laboratory Findings, and Outcomes of Disseminated Tuberculosis in Tehran, Iran

Hasibi, Mehrdad; Rasoulinejad, Mehrnaz; Hosseini, Seyed-Mahmoud Eshagh; Davari, Parastoo; Sahebian, A.; Khashayar, Patricia

doi:10.1097/smj.0b013e318180bcfd

Cited by 16 publications

(19 citation statements)

References 12 publications

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“…Most of our patients, 88 (80%), were less than 45 years old. The mean age of the population in this study (31.3±12.2 years) was younger than that mentioned in other reports, [6][7][8][9][10] but similar to that found in two hospital-based studies in Iran and Philippine [11,12].…”

Section: Discussion Demographycontrasting

confidence: 52%

“…Therefore the diagnosis of this disease is generally difficult and usually there is a delay in seeking medical help for more than one month by more than 50% of patients. This delay was noted here in addition to several other reports [2,[5][6][7][8][9][10][11][12]. Fever was the most common presenting symptom in many studies [2][3][4][5][6][7][8][9][10] as well as in our series.…”

Section: Clinical Featuressupporting

confidence: 44%

“…Skin testing is frequently unreliable and of no help in excluding or confirming the disease. Miliary infiltrates (on chest radiograph or CT) were present in 77 (77%) of our patients, which falls within the range of 29-89% reported in different studies [2,3,[5][6][7][8][9][10][11][12].…”

Section: Investigations and Proceduresmentioning

confidence: 57%

“…Fever was the most common presenting symptom in many studies [2][3][4][5][6][7][8][9][10] as well as in our series. Disseminated TB can involve many organs, with the lungs being the commonly involved [2][3][4][5][6][7][8][9][10][11][12]. The lungs were involved most frequently in our study, followed by meninges.…”

Section: Clinical Featuresmentioning

confidence: 91%

“…It must be subjected to smear and mycobacterial culture examination. The sensitivity of sputum acid-fast smear was 6-36%, [2,5,7,10] while the frequency of a positive sputum culture for M. tuberculosis was 27-97% [2][3][4][5][6][7][8][9][10][11][12]. In our study, sputum smear showed acid fast bacilli in 43% (36/84), and culture was positive in 91.6% (77/84) of the cases.…”

Section: Investigations and Proceduresmentioning

confidence: 99%

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Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A Five Year Hospital Based Study

Khan¹,

Dosa²,

Fuad³

et al. 2016

Mycobact Dis

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Objectives: To describe the demographic, clinical features, diagnostic and procedure results, organ involvement and outcomes in patients with disseminated tuberculosis (TB). Patients and methods:This retrospective observational study was conducted at Hamad general hospital in Qatar. It involved all patients 15 years of age or older who were admitted to Hamad general hospital with disseminated TB from January 1, 2006 to December 31, 2010. Results:We enrolled 100 patients. There were 74 (74%) males and the mean age (±SD) of patients was 31.3±12.2. The most common presenting symptom was fever (95%). Fifteen (15%) patients had other underlying medical conditions; the most common being diabetes mellitus 7 (7%), while two patients had human immunodeficiency virus (HIV) infection. The tuberculin skin test was positive in 42 (42%) patients. Sputum and gastric lavage examination were performed in 84 (84%) and 9 (9%) patients respectively while bronchoscopy was performed on 32 (32%) cases.Most patients 94 (94%) completed their treatment in Qatar whereas (3%) left the country before completion. The in-hospital mortality rate was 3% (3 patients). Systemic corticosteroids were prescribed for 36 (36%) cases and 15 patients had complications, the most being tuberculoma 9/23 (39.1%). Drug toxicity was noted in 17 (17%) patients, including hepatitis, optic neuritis and hyperurecemia. Only presence of underlying medical conditions was found to be an independent predictor of mortality.Conclusions: Disseminated TB has a non-specific clinical picture, gives rise to high morbidity and mortality and therefore demands a high index of suspicion to promptly diagnosis and initiate timely treatment.

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Section: Discussion Demographycontrasting

confidence: 52%

Section: Clinical Featuressupporting

confidence: 44%

Section: Investigations and Proceduresmentioning

confidence: 57%

Section: Clinical Featuresmentioning

confidence: 91%

Section: Investigations and Proceduresmentioning

confidence: 99%

See 3 more Smart Citations

Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A Five Year Hospital Based Study

Khan¹,

Dosa²,

Fuad³

et al. 2016

Mycobact Dis

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Pulmonary Mycobacterial Infections in Patients with Hematological Malignancies

Al-Anazi

Al-Jasser

2010

Pulmonary Involvement in Patients With Hematological Malignancies

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Lethal Tuberculosis in a Previously Healthy Adult with IL-12 Receptor Deficiency

et al. 2011

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A 33-year-old man was admitted in hospital due to fever, generalized lymphadenopathy, and hepatosplenomegaly. He had a history of anti-tuberculosis treatment in the previous 3 years. Despite normal chest radiograph, a sputum sample was smear-positive for acid-fast bacilli, and polymerase chain reaction was positive for Mycobacterium tuberculosis complex. Drug susceptibility test revealed resistance to isoniazid and rifampin. Evaluation of the patient's immune system revealed IL-12Rβ1 deficiency. The patient died of disseminated tuberculosis (TB), despite appropriate antibiotic treatment. This is the first IL-12 receptor-deficient patient presenting with disseminated TB in adulthood, without any previous relevant medical history. This diagnosis should be considered in selected adult patients with unexplained, overwhelming TB. IL-12Rβ1 deficiency is a genetic etiology of severe TB in adults and should be considered in adult patients with disseminated TB.

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Epidemiological, Clinical, Laboratory Findings, and Outcomes of Disseminated Tuberculosis in Tehran, Iran

Abstract: Disseminated TB could have different manifestations. Hematologic abnormalities are common and are considered poor prognostic signs in these patients.

Cited by 16 publications

References 12 publications

Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A Five Year Hospital Based Study

Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A Five Year Hospital Based Study

Pulmonary Mycobacterial Infections in Patients with Hematological Malignancies

Lethal Tuberculosis in a Previously Healthy Adult with IL-12 Receptor Deficiency

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