[Tuberculosis and systemic diseases. Apropos of 16 cases].
METHODS
We analyzed retrospectively 16 patients between 1976 and 1993 (six men, ten women, mean age: 49-year-old) suffering from connectivitis. HIV-negative and receiving corticosteroids, combined for six of them with immunosuppressive therapy, and suffering from tuberculosis.


RESULTS
The mean period between first signs and diagnosis was 51 days (3-190 d). Tuberculosis was pulmonary (n = 10) of which 4 miliary, pleurisy (n = 3), lymphadenitis (n = 5). We only observed one meningitis, one otitis and one female genital tuberculosis. Six patients had more than one localisation. Diagnosis was proven bacteriologically eight times, histologically six times and for three patients diagnosis was certain because of efficacy of antituberculosis antibiotherapy. Evolution was always good, with antituberculosis antibiotherapy of maximum 18 months, without sequella. Because rifampicin enzymatic induction, connectivitis worsened in five patients. An increase in corticotherapy was necessary for these five patients.


CONCLUSIONS
This series confirmed the frequently extrapulmonary feature of tuberculosis in immunosuppressed patients, the long delay of diagnosis and the risk of exacerbation of underlying disease with rifampicin.
Service de médecine interne, hôpital de la Pitié-Salpêtrière, Paris, France.
C
C
Darras-Joly
B
B
Wechsler
O
O
Blétry
L T
LT
Du
G
G
Raguin
P
P
Godeau
J C
JC
Piette
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D003240:Connective Tissue Diseases / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D007166:Immunosuppressive Agents
Tuberculose maladie et maladies systémiques. A propos de 16 cas.