Unsuspected pulmonary tuberculosis in a community teaching hospital.
Tuberculosis remains a significant clinical and public health problem in the United States. To determine if a significant proportion of hospitalized patients diagnosed as having pulmonary tuberculosis were not suspected of the disease following initial patient assessment, we retrospectively reviewed the microbiology records of a 515-bed community teaching hospital and identified all patients with culture-proven Mycobacterium tuberculosis infection hospitalized between January 1983 and December 1987. Pulmonary tuberculosis was not suspected in 13 (42%) of 31 patients with active disease. These patients were elderly (92% aged 65 years or older vs 8% aged less than 65 years), had a delay in respiratory isolation (6 vs 1 days) and diagnosis (8 vs 3 days), in addition to a longer hospitalization (16 vs 11 days) with increased mortality (46% vs 11%). Inadequate diagnosis may contribute to the persistence of morbidity and mortality from tuberculosis in this country.
Counsell
S R
SR
Department of Medicine, Akron (Ohio), City Hospital, Northeastern Ohio Universities, College of Medicine.
Tan
J S
JS
Dittus
R S
RS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006764:Hospitals, Community; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010356:Patient Isolation; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality