Extra-pulmonary manifestations in a large metropolitan area with a low incidence of tuberculosis.
Int J Tuberc Lung Dis
; 7(12): 1178-85, 2003 Dec.
Article
em En
| MEDLINE
| ID: mdl-14677893
ABSTRACT
BACKGROUND:
The increases in extra-pulmonary tuberculosis (EPTB) have been largely due to human immunodeficiency virus co-infection. The rates of EPTB have remained constant despite the decline in pulmonary tuberculosis (PTB) cases.OBJECTIVE:
To evaluate covariates associated with EPTB.METHODS:
A 4-year cohort of EPTB patients was compared with PTB cases. Enrollees were assessed for TB risk, medical records were reviewed, and Mycobacterium tuberculosis isolates were fingerprinted.RESULTS:
We identified 538 EPTB cases (28.6%) in a total of 1878 enrollees. The most common sites of infection were lymph nodes (43%) and pleura (23%). EPTB cases included 320 (59%) males, 382 (71%) patients were culture-positive, and 332 (86.9%) patient isolates were fingerprinted. Fewer EPTB than PTB patients belonged to clustered M. tuberculosis strains (58% vs. 65%; P = 0.02). A multivariate model identified an increased risk for EPTB among African Americans (OR = 1.9, P = 0.01), HIV-seropositive (OR = 3.1, P < 0.01), liver cirrhosis (OR = 2.3, P = 0.02), and age <18 years (OR = 2.0, P = 0.04). Patients with concomitant pulmonary and extra-pulmonary infections were more likely to die within 6 months of TB diagnosis (OR = 2.3, P < 0.01).CONCLUSIONS:
African American ethnicity is an independent risk factor for EPTB. Mortality at 6 months is partly due to the dissemination of M. tuberculosis and the severity of the underlying co-morbidity.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose
/
Etnicidade
/
Infecções Oportunistas Relacionadas com a AIDS
/
Mycobacterium tuberculosis
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos