A comparative study of clinical manifestations caused by tuberculosis in immunocompromised and non-immunocompromised patients.
OBJECTIVE
To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.


METHODS
Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs.


RESULTS
Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1% vs 35.5%), pulmonary moist rale (41.0% vs 9.2%), miliary pulmonary tuberculosis (30.8% vs 2.6%), pleural effusion (48.7% vs 25.0%) and lymphadenopathy (18.0% vs 4.0%). ICPs had less lung cavity (15.4% vs 22.4%) and pleural thickening (15.4% vs 23.7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1% vs 6.6%). Pulmonary tuberculosis was found in the apicoposterior segment (SI + SII) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs.


CONCLUSIONS
The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.
Shao
Changzhou
C
Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Qu
Jieming
J
He
Lixian
L
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis; D014391:Tuberculosis, Miliary / Q000175:diagnosis; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000503:physiopathology*