Objective To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.Methods Underlying diseases, clinical pres...Objective To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.Methods Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs.Results Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1 % vs 35. 5%), pulmonary moist rale (41. 0% vs 9. 2%), miliary pulmonary tuberculosis (30. 8% vs 2. 6%), pleural effusion (48. 7% vs 25. 0%) and lymphadenopathy (18. 0% vs 4. 0 %). ICPs had less lung cavity (15. 4% vs 22. 4%) and pleural thickening (15. 4% vs 23. 7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1 % vs 6. 6%). Pulmonary tuberculosis was found in the apicoposterior segment (SⅠ+SⅡ) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs.Conclusion The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.展开更多
基金the Training Project of Shanghai Health System (No. 98 BR030).
文摘Objective To characterize the differences between clinical manifestations in immunocompromised patients (ICPs) and non-immunocompromised patients (non-ICPs) with tuberculosis.Methods Underlying diseases, clinical presentations, misdiagnosis, treatment and prognosis, etc, were analyzed retrospectively in 115 tuberculosis patients, including 39 ICPs and 76 non-ICPs.Results Compared with non-ICPs, the individuals who were ICP had more expectoration (64.1 % vs 35. 5%), pulmonary moist rale (41. 0% vs 9. 2%), miliary pulmonary tuberculosis (30. 8% vs 2. 6%), pleural effusion (48. 7% vs 25. 0%) and lymphadenopathy (18. 0% vs 4. 0 %). ICPs had less lung cavity (15. 4% vs 22. 4%) and pleural thickening (15. 4% vs 23. 7%) compared to non-ICPs. Pulmonary tuberculosis in ICPs was prone to be misdiagnosed as pneumonia (23.1 % vs 6. 6%). Pulmonary tuberculosis was found in the apicoposterior segment (SⅠ+SⅡ) in more cases in non-ICPs (21.7%, 10/46) than ICPs (10.3%, 3/29). The diagnostic value of tuberculin skin test and adenosine deaminase in pleural effusions was limited in ICPs. ICPs had significantly poorer prognoses than non-ICPs.Conclusion The clinical manifestations of ICPs with tuberculosis are atypical, misdiagnosis often occurs, resulting in a worse prognosis.
