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

Abstract

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.

Transudative or masked exudative polyserositis in disseminated tuberculosis? A case report

“…The definition of disseminated TB involves hematogenous dissemination Mycobacterium tuberculosis in two or more non-contiguous sites. It can occur through primary focus, reactivation of latent TB (post-primary TB) or rarely through iatrogenic origin [ 1 , 3 ]. The occurrence of disseminated has been significantly shown with immunocompromised people by various studies [ 1 , 3 , 8 , 9 ].…”

“…It can occur through primary focus, reactivation of latent TB (post-primary TB) or rarely through iatrogenic origin [ 1 , 3 ]. The occurrence of disseminated has been significantly shown with immunocompromised people by various studies [ 1 , 3 , 8 , 9 ]. The exact mechanism for dissemination is still unclear.…”

“…The disseminated TB presents with non-specific signs and symptoms based on the organs involved. It can range from anorexia, fever with chills and rigor, cough, weight loss, fatigue, lymphadenopathy, ascites, pleural and pericardial effusion and anemia [ 1 , 3 ]. The less common symptom our patient had was watery diarrhea which was common in children [ 3 ].…”

“…TB has various forms of presentation, common being pulmonary and extra-pulmonary forms. Disseminated TB can be simply defined as lymphohematogenous dissemination of tubercle bacilli in two or more non-contiguous sites [ 1 ]. The variety of presentations in disseminated TB makes its diagnosis a difficult one [ 2 , 3 ].…”

Chronic Myeloid Leukemia Preceded by Tuberculosis

“…Historically, it was called "consumption" due to the weight loss. Infections of other organs can cause a wide range of symptoms [1].…”