title: Causes of early mortality in HIV-infected TB suspects in an East African referral hospital.
abstract: BACKGROUND
  Respiratory infections are a leading cause of death in Africa, especially among HIV-infected patients. Data on the etiology of fatal respiratory diseases are largely based on autopsy studies. We evaluated causes of pneumonia associated with early mortality among hospitalized HIV-infected patients in Kampala, Uganda.
  
  
  METHODS
  Prospective cohort study of HIV-infected patients admitted to Mulago Hospital, Kampala, with at least 2 weeks of cough. Consecutively enrolled patients with negative Ziehl Neelsen sputum smears for acid-fast bacilli underwent bronchoscopy with bronchoalveolar lavage and examination for mycobacteria (smear, solid culture), Pneumocystis jirovecii (Giemsa stain), and fungi (KOH mount, India ink stain, Sabouraud culture). Early mortality was defined as death before the 2-month follow-up visit.
  
  
  RESULTS
  Follow-up data were available for 353 (87%) of 407 patients enrolled. Of participants with follow-up data, 112 (32%) died within 2 months. Among patients with early mortality, a diagnosis was confirmed in 74 (66%), including tuberculosis (TB) (56%), cryptococcal pneumonia (1%), Pneumocystis pneumonia (3%), pulmonary Kaposi sarcoma (4%), and pneumonia caused by 2 or more disease processes (3%).
  
  
  CONCLUSIONS
  Mortality in HIV-infected TB suspects is high, with TB associated with the largest proportion of deaths. A significant proportion of patients die without a confirmed diagnosis.
authors.affiliation: Makerere University, Kampala, Uganda. smilin.rasasa@gmail.com
authors.forename: Rachel
authors.initials: R
authors.lastname: Kyeyune
authors.forename: Saskia
authors.initials: S
authors.lastname: den Boon
authors.forename: Adithya
authors.initials: A
authors.lastname: Cattamanchi
authors.forename: J Lucian
authors.initials: JL
authors.lastname: Davis
authors.forename: William
authors.initials: W
authors.lastname: Worodria
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Yoo
authors.forename: Laurence
authors.initials: L
authors.lastname: Huang
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000401:mortality*; D000328:Adult; D002423:Cause of Death; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012017:Referral and Consultation; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000401:mortality*; D014454:Uganda / Q000453:epidemiology