Arciniegas William, Orjuela Dora Luisa
Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia.
Biomedica. 2006 Mar;26(1):71-80; discussion 81.
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.
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.
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.
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.
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.
结核病在全球范围内仍然是一个严重的公共卫生问题。在当地机构层面，必须从诊断效率和资源的充分利用方面评估该问题的严重程度。
确定疾病病灶，并总结一家三级公立医院的流行病学、临床、微生物学和诊断数据以及相关的医院成本。
对2000年至2004年间在哥伦比亚佩雷拉的圣豪尔赫大学医院出院的102例肺外结核患者的临床记录进行了回顾性研究。
患者平均年龄为31.6岁；62.7%为男性，70.6%为城市居民。最常见的类型是胸膜结核，共47例，其次是脑膜结核（19例）、淋巴结炎（13例）、腹膜结核（5例）、粟粒性结核（4例）、泌尿生殖系统结核（4例）、咽结核（4例）、骨关节结核（3例）、骨结核（2例）和心包结核（1例）。诊断方法中，68例（66.6%）采用活检，28例（27.4%）采用临床诊断。萋尼氏染色诊断出3.9%的病例，细菌培养诊断出5.8%的病例。平均住院时间为13天。平均费用为每例2410美元。15例患者死亡；其中9例患有艾滋病，8例患有脑膜炎。
最常见的肺外结核类型是胸膜结核、脑膜结核和淋巴结炎。主要诊断方法是活检。住院时间延长与诊断延迟和艾滋病感染有关。最高死亡率与艾滋病和结核性脑膜炎有关。
