title: [Extended pulmonary tuberculosis and immunocompetence: causes and consequences].
abstract: BACKGROUND
  Despite scientific advances, extended forms of pulmonary tuberculosis are still relevant. The aim of our study was to determine clinical features and outcome of extended pulmonary tuberculosis in immunocompetent patients.
  
  
  METHODS
  Retrospective comparative study including 100 patients HIV negative, presenting pulmonary tuberculosis divided into 2 groups of 50 patients (group1: extended tuberculosis and group2: localized tuberculosis). Tuberculosis was considered extended when reaching above one lobe.
  
  
  RESULTS
  The average age was comparable in the 2 groups (p = 0.138). In group1, we noted a higher incidence of diabetes (p = 0.037) and malnutrition (p = 0.045). Clinically, patients in group1 had more general signs (p=0.033) and dyspnoea (p=0.037). Biologically, anemia (p<0.001), leukocytosis (p=0.05), elevated CRP (p=0.031), thrombocytosis (p=0.023), hyponatremia (p = 0.001) and liver disturbances (p = 0.001) were significantly more frequent in group1. Concerning the evolution, time to smear negativity was significantly longer (p=0.012). Similarly, radiological sequelae were more frequent (p = 0.02) and more extensive (p = 0.012). Positive predictive value of radiological extent in disease evolution was 62% with a confidence interval between 47.2% and 75%.
  
  
  CONCLUSIONS
  The extent of pulmonary tuberculosis is an important factor in clinical and biological presentation and disease evolution. Indeed, patients with extended tuberculosis develop more severe presentation and are more likely to develop parenchymal sequelae.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ben Nasr
authors.forename: Nawel
authors.initials: N
authors.lastname: Chaouch
authors.forename: Sawssen
authors.initials: S
authors.lastname: Bacha
authors.forename: Sana
authors.initials: S
authors.lastname: Cheikh Rouhou
authors.forename: Hajer
authors.initials: H
authors.lastname: Racil
authors.forename: Mourad
authors.initials: M
authors.lastname: Zarrouk
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Chabbou
mesh_terms: D000328:Adult; D000740:Anemia / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D007010:Hyponatremia / Q000453:epidemiology; D016867:Immunocompromised Host; D007964:Leukocytosis / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology; D012189:Retrospective Studies; D013922:Thrombocytosis / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D014416:Tunisia / Q000453:epidemiology
chemical_list: D002097:C-Reactive Protein