Mycobacterium tuberculosis infection in cancer patients at a tertiary care cancer center in Japan.
The characteristics of active tuberculosis in cancer patients in Japan and the effects of this infection on cancer treatment have not yet been clarified. The records of all consecutive patients with microbiologically documented Mycobacterium tuberculosis infection diagnosed between September 2002 and March 2008 at Shizuoka cancer center (a 557-bed tertiary care cancer center in Japan) were reviewed. There were 24 cancer patients with active tuberculosis during the study period. Of these, 23 had solid-organ tumors, and the most common site of the underlying malignancy was the lung. Most of the patients had pulmonary tuberculosis. Among 15 patients followed up for more than 2 months prior to the diagnosis of pulmonary tuberculosis, 12 had healed scars suggestive of old tuberculosis lesions, as shown by chest imaging obtained at the time of the initial evaluation. Discontinuation of cancer therapy or more than a month's delay in surgery occurred in 10 patients with pulmonary tuberculosis. Development of active tuberculosis can delay cancer treatment in Japanese centers. Cancer patients with scars suggestive of old tuberculosis disease lesions as shown by chest imaging should be screened for active tuberculosis and carefully followed up. In some cases, prophylactic treatment should be considered.
Department of Infectious Disease, Tokyo Women's Medical University, Tokyo, Japan; Department of Infectious Diseases, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan. Electronic address: fujita.takahiro@twmu.ac.jp.
Takahiro
T
Fujita
Division of Diagnostic Radiology, Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
Masahiro
M
Endo
Department of Regional Cooperation for Infectious Diseases, Tohoku University Graduate School of Medicine, Sendai, Japan.
Yoshiaki
Y
Gu
Department of Clinical Laboratory, Yamagata University Hospital, Yamagata, Japan.
Tomoaki
T
Sato
Disease Control and Prevention Center, National Center for Global Health and Medicine Hospital, Tokyo, Japan.
Norio
N
Ohmagari
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D063128:Tertiary Health Care; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000473:pathology*
D000970:Antineoplastic Agents
Anti-tumor agents; Cancer; Immunocompromised host; Tuberculosis