[Management of mycobacteriosis in general hospital without isolation ward for tuberculosis patients. 5. The management of the patients excreting tubercle bacilli in a university hospital without isolation ward for tuberculosis].
The Japanese low ruled that the patients excreting tubercle bacilli should be treated in the isolated ward for tuberculosis. However, it is often difficult to transfer a patient with serious illness to the isolated ward with insufficient medical facilities. We investigated retrospectively the manner of the management of patients excreting tubercle bacilli in the Aichi Medical University Hospital without the isolation ward for tuberculosis. Materials were 166 patients (0.17%) out of 97,275 in-patients during 11 years since 1986 to 1996. Respiratory symptoms were observed in 114 patients (68.7% of 166 patients) on admission. The initial bacteriological examination was ordered by the attendant doctor within a week in 93 patients (81.6%) of 114 patients with respiratory symptoms. On the other hand, a half of the 52 patients without respiratory symptoms on admission were not examined for sputum bacteriology beyond a week. Anti-tuberculous treatment was started within a week after positive bacteriological results in 129 patients (77.7% of the whole 166 patients), while the treatment was not carried out or delayed in 21 patients (12.6%) because of the communication failure of the bacteriological report to the physicians. Some complications were observed in 101 patients: 21 diabetes mellitus, 20 cancers, 15 hematological disorders, 9 collagen diseases, 6 renal failures on dialysis. Serious illnesses were observed in 33 patients (20.6% of the 166 patients). Twenty-four patients (73% of the seriously ill patients) were died of renal failure, pancytopenia, cancer or respiratory failure. We considered that an isolated room for infectious tuberculosis with independent air conditioning system in a general hospital or a educational hospital was very convenient not only to the treatment of the patients with serious complications, but also to the education and training on tuberculosis for the medical student or medical stuffs.
Kato
H
H
Second Department of Internal Medicine, Aichi Medical University, Japan.
Sakurai
E
E
Morishita
M
M
Oki
Y
Y
Watanabe
K
K
Kawajiri
T
T
Miyara
H
H
Shanzhong
Y
Y
Nitta
M
M
Inoue
M
M
D000328:Adult; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D014397:Tuberculosis, Pulmonary / Q000628:therapy*