Hasibi Mehrdad, Rasoulinejad Mehrnaz, Hosseini Seyed-Mahmoud Eshagh, Davari Parastoo, Sahebian Azadeh, Khashayar Patricia
Amir-Alam Hospital, Medical Sciences/University of Tehran, Tehran, Iran.
South Med J. 2008 Sep;101(9):910-3. doi: 10.1097/SMJ.0b013e318180bcfd.
Disseminated tuberculosis (TB) accounts for 1 to 3% of all TB cases. This retrospective study reviews the clinical, radiological, laboratory findings and outcome in patients with disseminated tuberculosis in an endemic area.
Medical records were reviewed for patients with disseminated TB admitted to two tertiary centers in Tehran, Iran between 1999 and 2006.
Fifty patients were found to have disseminated TB. A miliary pattern was documented in the chest x-ray of 34 patients. Hematologic abnormalities including anemia, leukopenia, and thrombocytopenia were frequently observed. Death occurred in nine of the cases. The mortality rate was significantly higher in diabetic patients, injection drug users, and patients with hematologic abnormalities; however, steroid usage and human immunodeficiency virus infection were not significantly associated with a higher mortality rate. Clinical improvement occurred in 41 patients following treatment.
Disseminated TB could have different manifestations. Hematologic abnormalities are common and are considered poor prognostic signs in these patients.
播散性结核病（TB）占所有结核病病例的1%至3%。本回顾性研究对某流行地区播散性结核病患者的临床、影像学、实验室检查结果及转归进行了分析。
回顾了1999年至2006年间在伊朗德黑兰两家三级医疗中心收治的播散性结核病患者的病历。
发现50例患者患有播散性结核病。34例患者胸部X线片显示粟粒样病变。常观察到血液学异常，包括贫血、白细胞减少和血小板减少。9例患者死亡。糖尿病患者、注射吸毒者和血液学异常患者的死亡率显著更高；然而，使用类固醇和感染人类免疫缺陷病毒与较高死亡率无显著相关性。41例患者治疗后临床症状改善。
播散性结核病可有不同表现。血液学异常常见，被认为是这些患者预后不良的征象。
