Abstract
Introduction: Miliary tuberculosis (MTB) represents almost 1-3% of all Tuberculosis cases and remains a potentially lethal disease if not diagnosed and treated timely. Formerly it was considered a childhood disease, but nowadays it is also recognized as a condition of adults, especially in immunosuppressed patients with HIV infection or by the use of biological agents and immunosuppressive drugs.
Objective: describe the clinical presentation and outcomes of hospitalized patients with MTB.
Methods: retrospective study over 10 years in patients admitted with MTB
Results: 53 patients were included. Mean age: 44 years; 77,4% males; 71,7% Caucasians and 28,3% Blacks. The comorbidities were: HIV infection (66%), alcoholism (28%), smoking (26%), hepatitis C (25%), drug addiction (23%) and malnutrition (23%). On admission, patients presented anemia (62%), hyponatremia (34%), acute renal failure (17%) and pancytopenia (7,5%). Beyond the micronodular pattern (91%), the patients presented with alveolar pattern (13,2%), reticular pattern (5,7%) and cavitation (3,8%). 51% patients had acid-fast bacillus sputum negative. In addition to lung location, 43% had Tuberculosis in another organ. The adverse reactions occurred in 28,5% (n=15) cases, 80% of them with hepatotoxicity. In HIV subgroup, adverse reactions occurred in 31,4%, 77,8% of them had CD4 count <200 cells/mm3. There were 2 cases of MDR-TB. The length of stay was 45 days and the mortality rate was 13,2% (n=7).
Conclusions: This study highlights the importance of HIV infection and risk behaviors in triggering MTB and points out the adverse reactions, prolonged hospitalization and in-hospital mortality as characteristic attributes of this condition.
- Copyright ©the authors 2016