title: Co-morbidities associated with tuberculosis in an autopsy case series.
abstract: A retrospective review of cases of tuberculosis examined by our Autopsy Division was undertaken to determine the most common associated co-morbidities. Forty-six cases of tuberculosis were examined between 2000 and 2010. The subpopulation of decedents studied included a large number of incarcerated individuals and showed an age distribution from 30 to 78 years. Thirty-five of the cases reviewed showed one or more co-morbidities, primarily viral hepatitis C, cancer, human immunodeficiency virus (HIV), cardiovascular diseases, and chronic obstructive pulmonary diseases. Almost 30% of the cases showed evidence of extrapulmonary disease, including one case of tuberculous meningitis. In approximately 20% of the cases, rapid progressive or disseminated tuberculosis was identified as immediate cause of death. Tuberculosis was the immediate cause of death in 20% of the hepatitis C-infected group and in 14% of the decedents diagnosed with cancer, compared to over 45% of the HIV-infected decedents. This observation is consistent with previous studies reporting an enhanced mortality from tuberculosis in HIV-infected subjects. Interestingly, rapid progressive tuberculosis was identified as immediate cause of death in two cases with no associated co-morbidities; both decedents were young immunocompetent adults, suggesting an increasing susceptibility of this subpopulation to tuberculosis exposure and to severe disease.
authors.affiliation: Department of Pathology, The University of Texas Medical Branch, Galveston, TX 77555-0747, USA. elsbrana@utmb.edu
authors.forename: Elena
authors.initials: E
authors.lastname: Sbrana
authors.forename: Joy
authors.initials: J
authors.lastname: Grise
authors.forename: Clarke
authors.initials: C
authors.lastname: Stout
authors.forename: Judith
authors.initials: J
authors.lastname: Aronson
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D060085:Coinfection / Q000453:epidemiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000473:pathology