UNASSIGNED: A retrospective chart review was conducted, including all patients diagnosed with miliary or DTB at KAMC with retrievable medical files.
UNASSIGNED: The study included 55 patients, of whom 35 (63.6%) were male and the median age was 64 years old. 35 (63.6%) of the infected patients were timely diagnosed and eventually cured from the illness. The most common comorbid conditions were diabetes, chronic kidney disease, and immunocompromising conditions, which were present in 37 (67.2%), 12 (21.8%), and 11 (20%) of the patients, respectively. The most common presenting symptoms were fever and cough, present in 31 (56.3%) and 26 (47.2%) of the patients, respectively, followed by weight loss in 25 (45.4%), night sweats in 15 (27.2%), and shortness of breath in 14 (25.4%). Approximately two-thirds of the patients had pulmonary miliary TB (MTB) (38; 69.1%), followed by TB lymphadenitis (21; 38.2%), central nervous system involvement (13; 23.6%), skeletal involvement (11; 20%), gastrointestinal involvement (5; 9.1%), pleural involvement (3; 5.5%), and urogenital TB (2; 3.6%). The mortality rate was 14 (25.5%) patients.
UNASSIGNED: MTB is challenging to diagnose due to nonspecific clinical, laboratory, and imaging findings. Clinicians dealing with patients who are at risk of developing DTB should be aware of the typical presentations and abnormal clinical findings. They should also have a low threshold to initiate specific investigations for the disease, as early diagnosis and effective treatment is critical in reducing morbidity and mortality rates.
■进行了回顾性图表审查,包括所有在KAMC诊断为milsiary或DTB的患者,并提供可检索的医疗文件。
■该研究包括55名患者,其中35人(63.6%)为男性,中位年龄为64岁。35例(63.6%)感染患者得到及时诊断并最终治愈。最常见的合并症是糖尿病,慢性肾病,和免疫受损的条件,其中37人中存在(67.2%),12(21.8%),和11名患者(20%),分别。最常见的症状是发烧和咳嗽,在31例(56.3%)和26例(47.2%)患者中,分别,其次是25(45.4%)的体重减轻,15人中有盗汗(27.2%),和呼吸急促14例(25.4%)。大约三分之二的患者患有肺部沙粒性结核(MTB)(38;69.1%),其次是结核性淋巴结炎(21;38.2%),中枢神经系统受累(13;23.6%),骨骼受累(11;20%),胃肠道受累(5;9.1%),胸膜受累(3;5.5%),和泌尿生殖系统结核(2;3.6%)。死亡率为14例(25.5%)。
■由于非特异性临床,MTB的诊断具有挑战性,实验室,和成像发现。与有发展DTB风险的患者打交道的临床医生应了解典型的表现和异常的临床发现。他们还应该有一个较低的门槛来启动对这种疾病的具体调查,早期诊断和有效治疗对于降低发病率和死亡率至关重要。