Miliary tuberculosis epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic country

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dc.authorid0000-0001-8945-2385
dc.authorid0000-0001-8022-7325
dc.authorid0000-0002-9994-5033
dc.authorid0000-0001-9658-7560
dc.contributor.authorMert, Ali
dc.contributor.authorArslan, Ferhat
dc.contributor.authorKuyucu Yılmaz, Tülin
dc.contributor.authorKoç, Emine Nur
dc.contributor.authorYılmaz, Mesut
dc.contributor.authorTuran, Demet
dc.contributor.authorAltın, Sedat
dc.contributor.authorPehlivanoğlu, Filiz
dc.contributor.authorŞengöz, Gönül
dc.contributor.authorYıldız, Dilek
dc.contributor.authorDökmetaş, İlyas
dc.contributor.authorKömür, Süheyla
dc.contributor.authorKurtaran, Behice
dc.contributor.authorDemirdal, Tuna
dc.contributor.authorErdem, Hüseyin Aytaç
dc.contributor.authorSipah, Oğuz Reşat
dc.contributor.authorBatırel, Ayşe
dc.contributor.authorParlak, Emine
dc.contributor.authorTekin, Recep
dc.contributor.authorTunçcan, Özlem Güzel
dc.contributor.authorBalkan, İlker İnanç
dc.contributor.authorHayran, Osman
dc.contributor.authorCeylan, Bahadır
dc.date.accessioned2020-08-13T10:38:48Z
dc.date.available2020-08-13T10:38:48Z
dc.date.issued2017
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Halk Sağlığı Ana Bilim Dalı
dc.description.abstractThe aim of this study was to determine the clinical features, and outcome of the patients with miliary tuberculosis (TB). We retrospectively evaluated 263 patients (142 male, 121 female, mean age: 44 years, range: 16–89 years) with miliary TB. Criteria for the diagnosis of miliary TB were at least one of the followings in the presence of clinical presentation suggestive of miliary TB such as prolonged fever, night sweats, anorexia, weight loss: radiologic criterion and pathological criterion and/or microbiological criterion; pathological criterion and/or microbiological criterion. The miliary pattern was seen in 88% of the patients. Predisposing factors were found in 41% of the patients. Most frequent clinical features and laboratory findings were fever (100%), fatigue (91%), anorexia (85%), weight loss (66%), hepatomegaly (20%), splenomegaly (19%), choroid tubercules (8%), anemia (86%), pancytopenia (12%), and accelerated erythrocyte sedimentation rate (89%). Tuberculin skin test was positive in 29% of cases. Fifty percent of the patients met the criteria for fever of unknown origin. Acidfast bacilli were demonstrated in 41% of patients (81/195), and cultures for Mycobacterium tuberculosis were positive in 51% (148/ 292) of tested specimens (predominantly sputum, CSF, and bronchial lavage). Blood cultures were positive in 20% (19/97). Granulomas in tissue samples of liver, lung, and bone marrow were present in 100% (21/21), 95% (18/19), and 82% (23/28), respectively. A total of 223 patients (85%) were given a quadruple anti-TB treatment. Forty-four (17%) patients died within 1 year after diagnosis established. Age, serum albumin, presence of military pattern, presence of mental changes, and hemoglobin concentration were found as independent predictors of mortality. Fever resolved within first 21 days in the majority (90%) of the cases. Miliary infiltrates on chest X-ray should raise the possibility of miliary TB especially in countries where TB is endemic. Although biopsy of the lungs and liver may have higher yield rate of organ involvement histopathologicaly, less invasive procedures including a bone marrow biopsy and blood cultures should be preferred owing to low complication rates.
dc.identifier.citationMert, A., Arslan, F., Kuyucu Yılmaz, T., Koç, E. N., Yılmaz, M., Turan, D. ... Ceylan, B. (2017). Miliary tuberculosis epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic country. Medicine, 96(5). https://dx.doi.org/10.1097/MD.0000000000005875
dc.identifier.doi10.1097/MD.0000000000005875
dc.identifier.issn0025-7974
dc.identifier.issn1536-5964
dc.identifier.issue5
dc.identifier.scopusqualityQ2
dc.identifier.urihttps://dx.doi.org/10.1097/MD.0000000000005875
dc.identifier.urihttps://hdl.handle.net/20.500.12511/5722
dc.identifier.volume96
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherLippincott Williams and Wilkins
dc.relation.ispartofMedicineen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NoDerivatives 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nd/4.0/*
dc.subjectDiagnosis
dc.subjectMiliary Tuberculosis
dc.subjectPrognosis
dc.titleMiliary tuberculosis epidemiologicaland clinical analysis of large-case series from moderate to low tuberculosis endemic country
dc.typeArticle

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