Disseminated Tuberculosis among Adult Patients Admitted to Hamad General Hospital, Qatar: A Five Year Hospital Based Study

Abstract

Objectives: To describe the demographic, clinical features, diagnostic and procedure results, organ involvement and outcomes in patients with disseminated tuberculosis (TB). Patients and methods: This retrospective observational study was conducted at Hamad general hospital in Qatar. It involved all patients 15 years of age or older who were admitted to Hamad general hospital with disseminated TB from January 1, 2006 to December 31, 2010. Results: We enrolled 100 patients. There were 74 (74%) males and the mean age (±SD) of patients was 31.3±12.2. The most common presenting symptom was fever (95%). Fifteen (15%) patients had other underlying medical conditions; the most common being diabetes mellitus 7 (7%), while two patients had human immunodeficiency virus (HIV) infection. The tuberculin skin test was positive in 42 (42%) patients. Sputum and gastric lavage examination were performed in 84 (84%) and 9 (9%) patients respectively while bronchoscopy was performed on 32 (32%) cases. Most patients 94 (94%) completed their treatment in Qatar whereas (3%) left the country before completion. The in-hospital mortality rate was 3% (3 patients). Systemic corticosteroids were prescribed for 36 (36%) cases and 15 patients had complications, the most being tuberculoma 9/23 (39.1%). Drug toxicity was noted in 17 (17%) patients, including hepatitis, optic neuritis and hyperurecemia. Only presence of underlying medical conditions was found to be an independent predictor of mortality. Conclusions: Disseminated TB has a non-specific clinical picture, gives rise to high morbidity