Ebdrup L, Storgaard M, Jensen-Fangel S, Obel N
Department of Infectious Diseases, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark.
Scand J Infect Dis. 2003;35(4):244-6. doi: 10.1080/00365540310000274.
The objective of this study was to describe the symptoms, diagnostic measures and outcomes of extrapulmonary tuberculosis (ex-TB) in a Danish university clinic from 1990 to 1999. 48 patients with ex-TB were identified retrospectively and clinical and laboratory data extracted from the patient files. The majority were immigrants from Africa (71%). A direct connection between symptoms on admission and anatomical localization of TB was found in 83%. The main localizations of ex-TB were peripheral lymph nodes (n = 15) and the abdomen (n = 19). In 73% Mycobacterium tuberculosis could be cultured. One culture was resistant to isoniazide and 1 had decreased sensitivity to isoniazide and etambutol. Two patients relapsed with TB. Some pitfalls in diagnosing TB were found, as 13% had a normal erythrocyte sedimentation rate at presentation, 9% had a negative tuberculin skin test and fever was absent in 31% of the cases. The patients' subjective complaints on admission should guide the diagnostic procedures.
本研究的目的是描述1990年至1999年丹麦一家大学诊所肺外结核(ex-TB)的症状、诊断措施及结果。对48例肺外结核患者进行回顾性鉴定,并从患者病历中提取临床和实验室数据。大多数患者为非洲移民(71%)。83%的患者入院时症状与结核的解剖定位之间存在直接关联。肺外结核的主要发病部位为外周淋巴结(n = 15)和腹部(n = 19)。73%的患者可培养出结核分枝杆菌。1份培养物对异烟肼耐药,1份对异烟肼和乙胺丁醇敏感性降低。2例患者结核病复发。研究发现了一些结核病诊断中的陷阱,因为13%的患者就诊时红细胞沉降率正常,9%的患者结核菌素皮肤试验阴性,31%的病例无发热症状。患者入院时的主观主诉应指导诊断程序。