Original Article

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

Authors: Mehrdad Hasibi, MD, Mehrnaz Rasoulinejad, MD, Seyed-Mahmoud Eshagh Hosseini, MD, Parastoo Davari, MD, Azadeh Sahebian, MD, Patricia Khashayar, MD

Abstract

Background: Disseminated tuberculosis (TB) accounts for 1 to 3% of all TB cases. This retrospective study reviews the clinical, radiological, laboratory findings and outcome in patients with disseminated tuberculosis in an endemic area.


Methods: Medical records were reviewed for patients with disseminated TB admitted to two tertiary centers in Tehran, Iran between 1999 and 2006.


Results: Fifty patients were found to have disseminated TB. A miliary pattern was documented in the chest x-ray of 34 patients. Hematologic abnormalities including anemia, leukopenia, and thrombocytopenia were frequently observed. Death occurred in nine of the cases. The mortality rate was significantly higher in diabetic patients, injection drug users, and patients with hematologic abnormalities; however, steroid usage and human immunodeficiency virus infection were not significantly associated with a higher mortality rate. Clinical improvement occurred in 41 patients following treatment.


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


Key Points


* Different manifestations of disseminated tuberculosis make diagnosis difficult.


* Mortality was significantly related to hematologic abnormalities.


* No correlation was found between mortality and steroid usage and human immunodeficiency virus.

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