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Unsuspected Pulmonary Tuberculosis in a Community Teaching Hospital
Steven R. Counsell, MD;
James S. Tan, MD;
Robert S. Dittus, MD
Arch Intern Med. 1989;149(6):1274-1278.
Abstract
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• Tuberculosis remains a significant clinical and public health problem in the United States. To determine if a significant proportion of hospitalized patients diagnosed as having pulmonary tuberculosis were not suspected of the disease following initial patient assessment, we retrospectively reviewed the microbiology records of a 515-bed community teaching hospital and identified all patients with culture-proven Mycobacterium tuberculosis infection hospitalized between January 1983 and December 1987. Pulmonary tuberculosis was not suspected in 13 (42%) of 31 patients with active disease. These patients were elderly (92% aged 65 years or older vs 8% aged 65 years), had a delay in respiratory isolation (6 vs 1 days) and diagnosis (8 vs 3 days), in addition to a longer hospitalization (16 vs 11 days) with increased mortality (46% vs 11%). Inadequate diagnosis may contribute to the persistence of morbidity and mortality from tuberculosis in this country.
(Arch Intern Med. 1989;149:1274-1278)
Author Affiliations
From the Department of Medicine, Akron (Ohio) City Hospital, Northeastern Ohio Universities College of Medicine (Drs Counsell and Tan); the Division of General Internal Medicine, Department of Medicine, Regenstrief Institute for Health Care, Indiana University School of Medicine, Indianapolis (Drs Counsell and Dittus); and the Department of Medicine, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, Ind (Dr Dittus).
Footnotes
Accepted for publication March 3,1989.
Presented, in part, at the annual meeting of the Society of General Internal Medicine, Washington, DC, April 27, 1989.
Reprint requests to Akron City Hospital, Department of Medicine, 75 Arch St, Suite 303, Akron, OH 44304 (Dr Tan).
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