Frequency of tuberculosis at autopsies in a large hospital in Zagreb, Croatia: a 10-year retrospective study

Abstract

AimTo assess the frequency and forms of pulmonary tuberculosis at autopsy in a high-traffic hospital in the capital city of a country with a low tuberculosis incidence.MethodsWe performed a retrospective search of autopsy data from the period 2000 to 2009 at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia. We also examined patients’ records and histological slides.ResultsOf 3479 autopsies, we identified 61 tuberculosis cases, corresponding to a frequency of 1.8%. Active tuberculosis was found in 33 cases (54%), 23 of which (70%) were male. Of the 33 active cases, 25 (76%) were clinically unrecognized and 19 (76%) of these were male.ConclusionClinically undiagnosed tuberculosis accounted for a substantial proportion of active tuberculosis cases diagnosed at autopsy. Autopsy data may be an important complement to epidemiological data on tuberculosis frequency.

Factors Associated With Sputum Culture-Negative vs Culture-Positive Diagnosis of Pulmonary Tuberculosis

“…Postmortem studies in the pre-HIV era and in settings with varying TB burden have shown that it was common for clinicians to underrecognize TB . In this study, patients with culture-negative PTB were less likely to have cough, weight loss, and pulmonary cavitation, consistent with prior, more limited studies .…”

“…Postmortem studies in the pre-HIV era and in settings with varying TB burden have shown that it was common for clinicians to underrecognize TB. [21][22][23][24] In this study, patients with culture-negative PTB were less likely to have cough, weight loss, and pulmonary cavitation, consistent with prior, more limited studies. 4,9 The list of differential diagnoses in these patients can be broad, ranging from other slowly progressing infectious diseases such as histoplasmosis to autoimmune diseases such as sarcoidosis, making its diagnosis even more challenging.…”

Six-year analysis of postmortem examination records at a teaching hospital - demographic profile and causes of deaths

“…In a Croatian hospital, clinically undiagnosed active tuberculosis was diagnosed on autopsy in 33 subjects (54%), of which 70% were male. [18] In a meta-analysis, about one-third of death certificates were found to be erroneous and about half of the autopsies revealed findings that were not clinically suspected when the subjects were alive. [19] The proportion of deaths due to electrocution in KMD area was significantly higher than that in other areas (p = 0.00005; OR = 0.327).…”

Fatal Hemoptysis Due to Undiagnosed Pulmonary Tuberculosis

“…The majority of these cases were seen in the elderly; pulmonary tuberculosis accounted for 54% of these deaths, with miliary tuberculosis accounting for 35% (21). A Croatian study revealed active tuberculosis in 1.8% of cases, 76% of which were clinically unrecognized (22).…”