RT Journal Article
SR Electronic
T1 Miliary tuberculosis: Diagnosis difficulties and prognosis factors
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p2579
VO 38
IS Suppl 55
A1 Samira Aouadi
A1 Meriem Mjid
A1 Sonia Maalej
A1 Imen Bachouche
A1 Asma Ghariani
A1 Meherazia Bourguiba
A1 Ali Ben Kheder
A1 Ikram Drira
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p2579.abstract
AB Introduction: Miliary tuberculosis (MT) is a form of tuberculosis which is characterized by wide hematogenous dissemination of Mycobacterium tuberculosis into the human body. The clinical presentation.of MT is highly variable.Objective: The aim of this study is to describe diagnosis difficulties and prognosis factors of MT in Tunisian patients.Methods: A retrospective study was conducted in the female adult pulmonary department of the Tunis Chest Disease and Surgery Training Hospital between 2000 and 2010.Results: Seventeen patients were found to have MT. The average age was 50 years [12-89]. Past history of Tb was noted in 1 case. Five patients had Tb contact history. Factors of immunodepression noted in 9 patients were: elderly (n=7), pregnancy (n=1) and corticosteroid therapy (n=1). Immunology of HIV was negative in all patients. Main symptoms were cough and wasting syndrome (n=15). On admission, 7 patients had an acute respiratory failure. Cachexy was noted in 8 cases. Chest X ray showed diffuse miliary shadow in all cases. Diagnosis was confirmed in 7 patients, by microscopic sputum tests (n=5), pleural biopsy (n=1) and lymph node biopsy (n=1). In the other cases (n=10), diagnosis was retained by a high index of clinical suspicion. Multifocal Tb was noted in 5 cases. The extrapulmonary sites were: central nervous system (n= 3), pleura (n=2), vertebral bodies (n=1), lymphatic nodes (n=1). Antituberculous treatment was started in all cases. The outcome was favourable in 15 patients. Two elderly were dead. Tb relapse occurred in 2 cases.Conclusion: MT is a severe disease in witch treatment must be early even without diagnosis confirmation. Advanced age seems to be one important prognosis factors.