Skip Navigation LinksHome > March 2011 - Volume 19 - Issue 2 > The Untimely Misfortune of Tuberculosis Diagnosis at Death:...
Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3181f744a7
Original Articles

The Untimely Misfortune of Tuberculosis Diagnosis at Death: Twelve-Year Experience at an Urban Medical Center

Barragán, Maribel MPH*; Holtz, Meredith MD*; Franco-Paredes, Carlos MD, MPH*†; Leonard, Michael K. MD*

Collapse Box

Abstract

Introduction: Most of the burden of tuberculosis (TB) in the United States resides in underserved minorities in the inner city. Prompt diagnosis and initiation of therapy are crucial.

Methods: We performed a retrospective review for a 12-year period of a major inner city hospital in the United States to identify cases of TB diagnosed at the time of death or postmortem.

Results: We identified 35 cases for a 12-year period. Of these, 33 (94%) were culture-confirmed cases of TB. At the time of autopsy, 6 cases (17%) were identified. In all these cases, there was no clinical suspicion of TB. Pulmonary TB was confirmed in 27 (77%) of the 35 patients, whereas 8 (23%) of the 35 had extrapulmonary TB. Of those with extrapulmonary TB, 6 patients had disseminated TB; 1, peritoneal TB; and 1, meningeal TB.

Discussion: Clinicians serving underserved populations with high human immunodeficiency virus infection/ acquired immune deficiency syndrome prevalence or other comorbidities such as diabetes and/or with currently high TB prevalence rates and high clinical suspicion of acute disseminated forms of TB even without bacteriologic confirmation, a therapeutic trial of antituberculous drugs should be entertained among those patients in whom there is strong clinical suspicion.

© 2011 Lippincott Williams & Wilkins, Inc.

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.