title: [Spectrum of tuberculous diseases in a pulmonary outpatient clinic].
abstract: BACKGROUND
  Although the incidence of 6.6 newly diagnosed tuberculosis (TB) cases per 100,000 inhabitants is in decline in Germany, TB remains a disease of significant epidemiologic importance.
  
  
  METHODS
  From 04/2001 to 07/2008, a total of 75 TB patients of an internal-pulmonary outpatient clinic had been treated (0.5% of all patients). 58 (77.3%) patients fulfilled the criteria of an active TB, 17 (22.7%) of latent tuberculous infection (LTBI). 68.0% were male (average age men 39.3 +/- 16.9 years [mean +/- standard deviation], women 46.8 +/- 21.5 years; p = not significant). 69.3% of the patients were born in Germany, 30.7% abroad. 84.5% patients had isolated pulmonary, 8.6% additional organ involvement, and 6.9% isolated extrapulmonary TB. 62.1% of active TB cases were microbiologically proven (51.7% microscopically, 43.1% in addition culturally, 6.9% exclusively culturally, 19.0% by polymerase chain reaction [PCR]).
  
  
  RESULTS
  Of 23 tests, 52.2% were fully sensitive against the most important first-line drugs ethambutol (M), isoniazid (H), rifampicin (R), pyrazinamide (Z), und streptomycin (S). 13.0% had an isolated resistance against H (4.4%) or S (8.6%), 4.4% a multiple drug resistance (MDR) against R und H, 30.4% a polyresistance (S and H). Symptoms were quite often unspecific, not taken care of, or misinterpreted.
  
  
  CONCLUSIONS
  Diagnosis and therapy of an active or latent TB illness remains, an important task and challenge, necessitating an effective cooperation of outpatient, hospital, and health authority institutions.
authors.affiliation: Internistisch-Pneumologische Praxen, Leipzig, Germany. gerhard.hoheisel@t-online.de
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hoheisel
authors.forename: Matthias
authors.initials: M
authors.lastname: Vogtmann
authors.forename: Jörg
authors.initials: J
authors.lastname: Winkler
authors.forename: Christian
authors.initials: C
authors.lastname: Gessner
authors.forename: Stefan
authors.initials: S
authors.lastname: Hammerschmidt
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Seyfarth
authors.forename: Silke
authors.initials: S
authors.lastname: Reimann
authors.forename: Arne C
authors.initials: AC
authors.lastname: Rodloff
authors.forename: Adrian
authors.initials: A
authors.lastname: Gillissen
authors.forename: Hubert
authors.initials: H
authors.lastname: Wirtz
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D014396:Tuberculosis, Pleural / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents