Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades

Disseminated TB in inpatient deaths at a tertiary care centre: an autopsy study over three decades

BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB ca...

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Published in:The international journal of tuberculosis and lung disease Vol. 25; no. 4; pp. 271 - 276
Main Authors: Siakia, U. N., Vishwajeet, V., Kumar, R., Suri, V., Joshi, K., Radotra, B.
Format: Journal Article
Language:English
Published: France International Union Against Tuberculosis and Lung Disease 01-04-2021
International Union against Tuberculosis and Lung Disease (IUATLD)
Subjects:
Autopsies
Autopsy
Bone marrow
Diagnosis
Epidemiology
Fatalities
HIV
Humans
India - epidemiology
Inpatients
Intestine
Medical research
Organs
Pancreas
Reproductive organs
Retrospective Studies
Spleen
Tertiary Care Centers
Tuberculosis
Tuberculosis - mortality
India
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Summary:BACKGROUND: One of the most severe forms of TB, disseminated TB (dTB) is associated with significant mortality. A retrospective study was undertaken to assess the proportion of dTB among inpatient deaths and to describe the pathological spectrum of lesions. Associated comorbidities and missed dTB cases ante-mortem were also sought.METHODS: Data on autopsy-confirmed cases of dTB from over three decades (1988-2016) obtained from the departmental archives of the Post Graduate Institute of Medical Education and Research, Chandigarh, India, were reviewed for clinical details, as well as gross and histopathological findings. The proportion of autopsy-confirmed dTB were reported.RESULTS: During this period, a total of 243 autopsy-confirmed cases were retrieved. The organs most commonly involved in these cases were the lungs (90.1%), followed by the liver (72%), spleen (44%), kidneys (37%), bone marrow (17%), adrenals (12.2%), intestine (11.4%), pancreas (8.5%) and reproductive organs (6.9%). The brain was involved in 73.3% cases. In one third of cases, the diagnosis of TB was not suspected ante-mortem. Comorbid conditions were noted in 36.2% cases.CONCLUSION: A significant burden of dTB was noted among hospital inpatient deaths. Due to multi-organ involvement, dTB has atypical symptoms and may remain undiagnosed ante-mortem. Increased awareness and robust screening of TB cases are mandatory, particularly in patients with underlying comorbidities.
Bibliography:1027-3719(20210401)25:4L.271;1-
(R) Medicine - General
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.20.0802