Alexis LC, Maxwell CJ, Peters B, Frederick W, Delapenha R, McNeil JI; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1998 Sep 24-27; 38: 586 (abstract no. L-126).
Howard University Hospital, Washington, DC.
Purpose: To investigate an observed increase at our hospital in the proportion of extrapulmonary TB cases occurring in 1997. Method: The records of the Mycobacteria Laboratory were examined and all patients with EPTB from Jan. 1, 1997 to Dec. 31, 1997 were identified. A retrospective chart review was performed on those patients' charts. Mycobacteriology lab data were obtained from all confirmed TB cases at our hospital between January 1,1986 and December 31, 1995. Results: There were thirteen total cases of M. tuberculosis (MTB) identified in 1997 of which 7 (53.8%) were extrapulmonary. Of these 7 patients, 6 (85.7%) were male and one female. Three (42.9%) were HIV positive all of whom met the criteria for AIDS (mean CD4 count 74/ml). The patients ranged in age from 31 to 50 years (mean 38). All patients were racial minorities with 5 (71.4%) black and 2 (28.6%) Hispanic. Four patients were foreign-born. Underlying conditions included IVDU (28.6%), alcohol abuse (57.1%), diabetes mellitus (28.6%), and ESRD-DD (14.3%). Five patients presented with weight loss and six had pyrexia. No patient had a history of positive PPD, but three had positive PPD tests while hospitalized. One patient had a known history of TB and two had known exposure. No patient was neutropenic and 6/7 were anemic (mean Hct. 32%). Four patients were hyponatremic and 6/7 had low serum albumin levels. In the ten year period between 1986 and 1995, EPTB cases ranged between 8 and 30 percent of total TB cases with a mean of 18%. Conclusions: More than half the cases of MTB diagnosed at our hospital in 1997 were extrapulmonary, as opposed to the mean of 18% seen in the prior 10 years. Almost half of the patients were HIV positive in our study. More than half of our patients were foreign-born. All of our patients came from racial minority groups. These factors, in addition to increased public health emphasis in the control of TB, may have contributed to the observed increase in EPTB.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Female
- HIV Seropositivity
- Hospitals
- Hospitals, Teaching
- Hospitals, University
- Hospitals, Urban
- Humans
- Incidence
- Male
- Mycobacteria, Atypical
- Mycobacterium
- Mycobacterium tuberculosis
- Tuberculin Test
- Tuberculosis
- epidemiology
Other ID:
UI: 102188574
From Meeting Abstracts