Extrapulmonary tuberculosis: a review of 102 cases in Pereira, Colombia.

Abstract

Introduction. Tuberculosis continues to be a serious public health problem worldwide. At the local institutional level, the magnitude of the problem must be assessed in terms of diagnosis efficiency and adequate use of resources.
Objective. to determine the disease focus and to summarize the epidemiologic, clinical, microbiologic, and diagnostic data, along with associated hospital costs in a third level public hospital.
Materials And Methods. A retrospective study based on clinical records of 102 patients with extrapulmonary tuberculosis occurring between 2000 and 2004 and discharged from the Hospital Universitario San Jorge in Pereira, Colombia, was carried out.
Results. The average patient age was 31.6 years; 62.7% were men and 70.6% were urban dwellers. The most frequent form was pleural TB with 47 cases, followed by the meningeal (19), lymphadenitis (13), peritoneal (5), miliary (4), genitourinary (4), pharyngeal (4), osteoarticular (3), skeletal (2), and pericardial (1) forms. The diagnostic methods were biopsy in 68 cases (66.6%), and clinical diagnosis in 28 (27.4%). Zielh-Neelsen stain diagnosed 3.9% of cases and bacterial culture 5.8%. The average hospital stay was 13 days. The average cost was of US dollar 2,410 per case. Fifteen patients died; of these 9 had AIDS and 8 had meningitis.
Conclusions. The most frequent extrapulmonary forms were pleural tuberculosis, meningeal tuberculosis and lymphadenitis. The principal diagnostic method was the biopsy. A prolonged hospital stay was associated with a delay in diagnosis and AIDS infection. The highest mortality was associated with AIDS and the meningeal form of tuberculosis.