[The clinical features for tuberculosis in compromised hosts].
We investigated the clinical features and measures for tuberculosis with diabetes mellitus, AIDS, gastrectomy, malignant tumor, or receiving anti-tumor necrosis factor-alpha. In these days, tuberculosis patients with diabetes mellitus are increasing. Their tuberculosis is often found in advanced cases and the periods of symptomatics are short. In short, in tuberculosis with diabetes mellitus, the progress of tuberculosis is fast. Japanese patients of tuberculosis with AIDS are frequent in mid-life and increasing. Extra-pulmonary tuberculosis including disseminated tuberculosis is frequent with patients of AIDS. The prognosis of them is improved with the spread of HAART treatment. The most frequent occasion for gastrectomy is gastric cancer and the prognosis is good. Many of them are thin and malnutrition. The prognosis of tuberculosis with malignant tumor is bad, especially with lung cancer and malignant lymphoma. People receiving infliximab, an antitumor necrosis factor-alpha, are frequent to have onset of tuberculosis. Particularly, extra-pulmonary tuberculosis, including disseminated tuberculosis are often. Tuberculin reaction before receiving infliximab are weak. No one, receiving chemoprophylaxis, has onset of tuberculosis. When the rate of chemoprophylaxis increases, the number of tuberculosis patients decreases. Immunocompromised hosts need to be examined periodical or extraordinary when they had symptoms of tuberculosis to discover the onset of tuberculosis. To prevent the onset of tuberculosis, patients who previously infected tuberculosis should receive active chemoprophylaxis regardless of their age.
Yamagishi
Fumio
F
Department of Respiratory Diseases, National Hospital Organization Chiba-East National Hospital, Chiba, Japan. yamagisf@chibae.hosp.go.jp
D017088:AIDS-Related Opportunistic Infections; D048909:Diabetes Complications / Q000503:physiopathology; D005743:Gastrectomy; D006801:Humans; D016867:Immunocompromised Host; D009369:Neoplasms / Q000150:complications; D011379:Prognosis; D014376:Tuberculosis / Q000503:physiopathology*; D014409:Tumor Necrosis Factor-alpha / Q000009:adverse effects
D014409:Tumor Necrosis Factor-alpha