DISSEMINATED TUBERCULOSIS - A STUDY OF 62 CASES

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  • 1 January 1980
    • journal article
    • research article
    • Vol. 58  (21) , 835-842
Abstract
Sixty-two cases of disseminated tuberculosis (Mycobacterium tuberculosis), seen over a 6 yr period in a large teaching hospital, are reviewed. The commonest symptoms were cough, loss of weight and appetite, fever and general malaise. Headache, when present, was higly specific for meningeal involvement. Pyrexia, hepatomegaly, evidence of weight loss and adventitious chest sounds were the commonest physical signs. Hyponatremia, hypo-albuminemia and abnormal liver function were common. Severe hematological abnormalities were not present in any patient. The best diagnostic sources were sputum, bronchial brushings and biopsies of liver and bone marrow. Forty patients 64%) died; 31 deaths were directly attributable to disseminated tuberculosis. Twenty-five patients had associated diseases. More female patients and black patients died than did males, whites or coloreds (mixed race). The duration of symptoms prior to admission was, in general, long in comparison with the interval between admission and death. The need to consider disseminated tuberculosis early in the differential diagnosis of a wasting pyrexial illness with chest symptoms and signs, even in the absence of a miliary or miliary-like chest radiography, is stressed.

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