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Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies

BACKGROUND: Diseases caused by Mycobacterium tuberculosis (TB) among adult patients with hematological malignancies have rarely been investigated. METHODS: Adult patients with hematological malignancies at National Taiwan University Hospital between 1996 and 2009 were retrospectively reviewed. Patie...

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Autores principales: Chen, Chien-Yuan, Sheng, Wang-Huei, Cheng, Aristine, Tsay, Woei, Huang, Shang-Yi, Tang, Jih-Luh, Chen, Yee-Chun, Wang, Jaun-Yuan, Tien, Hwei-Fang, Chang, Shan-Chwen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241214/
https://www.ncbi.nlm.nih.gov/pubmed/22111760
http://dx.doi.org/10.1186/1471-2334-11-324
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author Chen, Chien-Yuan
Sheng, Wang-Huei
Cheng, Aristine
Tsay, Woei
Huang, Shang-Yi
Tang, Jih-Luh
Chen, Yee-Chun
Wang, Jaun-Yuan
Tien, Hwei-Fang
Chang, Shan-Chwen
author_facet Chen, Chien-Yuan
Sheng, Wang-Huei
Cheng, Aristine
Tsay, Woei
Huang, Shang-Yi
Tang, Jih-Luh
Chen, Yee-Chun
Wang, Jaun-Yuan
Tien, Hwei-Fang
Chang, Shan-Chwen
author_sort Chen, Chien-Yuan
collection PubMed
description BACKGROUND: Diseases caused by Mycobacterium tuberculosis (TB) among adult patients with hematological malignancies have rarely been investigated. METHODS: Adult patients with hematological malignancies at National Taiwan University Hospital between 1996 and 2009 were retrospectively reviewed. Patients with positive serology for HIV were excluded. TB disease is diagnosed by positive culture(s) in the presence of compatible symptoms and signs. The demographics, laboratory and, microbiological features, were analyzed in the context of clinical outcomes. RESULTS: Fifty-three of 2984 patients (1.78%) were diagnosed with TB disease. The estimated incidence was 120 per 100,000 adult patients with hematological malignancies. Patients with acute myeloid leukemia had a significantly higher incidence of TB disease than other subtypes of hematological malignancies (2.87% vs. 1.21%, p = 0.002, odds ratio, 2.40; 95% confidence interval, 1.39-4.41). Thirty-eight patients (72%) with non-disseminated pulmonary TB disease presented typically with mediastinal lymphadenopathy (53%), pleural effusion (47%) and fibrocalcific lesions (43%) on chest imaging. The 15 (28%) patients with extra-pulmonary disease had lower rates of defervescence within 72 h of empirical antimicrobial therapy (13% vs 45%, p = 0.03) and a higher 30-day in-hospital mortality (20% vs. 0%, p = 0.004) compared to those with disease confined to the lungs. CONCLUSIONS: TB disease is not uncommon among patients with hematological malignancies in Taiwan. Patients who received a diagnosis of extra-pulmonary TB suffered higher mortality than those with pulmonary TB alone. Clinicians should consider TB in the differential diagnoses of prolonged fever in patients with hematological malignancies, particularly in regions of high endemicity.
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spelling pubmed-32412142011-12-17 Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies Chen, Chien-Yuan Sheng, Wang-Huei Cheng, Aristine Tsay, Woei Huang, Shang-Yi Tang, Jih-Luh Chen, Yee-Chun Wang, Jaun-Yuan Tien, Hwei-Fang Chang, Shan-Chwen BMC Infect Dis Research Article BACKGROUND: Diseases caused by Mycobacterium tuberculosis (TB) among adult patients with hematological malignancies have rarely been investigated. METHODS: Adult patients with hematological malignancies at National Taiwan University Hospital between 1996 and 2009 were retrospectively reviewed. Patients with positive serology for HIV were excluded. TB disease is diagnosed by positive culture(s) in the presence of compatible symptoms and signs. The demographics, laboratory and, microbiological features, were analyzed in the context of clinical outcomes. RESULTS: Fifty-three of 2984 patients (1.78%) were diagnosed with TB disease. The estimated incidence was 120 per 100,000 adult patients with hematological malignancies. Patients with acute myeloid leukemia had a significantly higher incidence of TB disease than other subtypes of hematological malignancies (2.87% vs. 1.21%, p = 0.002, odds ratio, 2.40; 95% confidence interval, 1.39-4.41). Thirty-eight patients (72%) with non-disseminated pulmonary TB disease presented typically with mediastinal lymphadenopathy (53%), pleural effusion (47%) and fibrocalcific lesions (43%) on chest imaging. The 15 (28%) patients with extra-pulmonary disease had lower rates of defervescence within 72 h of empirical antimicrobial therapy (13% vs 45%, p = 0.03) and a higher 30-day in-hospital mortality (20% vs. 0%, p = 0.004) compared to those with disease confined to the lungs. CONCLUSIONS: TB disease is not uncommon among patients with hematological malignancies in Taiwan. Patients who received a diagnosis of extra-pulmonary TB suffered higher mortality than those with pulmonary TB alone. Clinicians should consider TB in the differential diagnoses of prolonged fever in patients with hematological malignancies, particularly in regions of high endemicity. BioMed Central 2011-11-23 /pmc/articles/PMC3241214/ /pubmed/22111760 http://dx.doi.org/10.1186/1471-2334-11-324 Text en Copyright ©2011 Chen et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/2.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chen, Chien-Yuan
Sheng, Wang-Huei
Cheng, Aristine
Tsay, Woei
Huang, Shang-Yi
Tang, Jih-Luh
Chen, Yee-Chun
Wang, Jaun-Yuan
Tien, Hwei-Fang
Chang, Shan-Chwen
Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title_full Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title_fullStr Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title_full_unstemmed Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title_short Clinical characteristics and outcomes of Mycobacterium tuberculosis disease in adult patients with hematological malignancies
title_sort clinical characteristics and outcomes of mycobacterium tuberculosis disease in adult patients with hematological malignancies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3241214/
https://www.ncbi.nlm.nih.gov/pubmed/22111760
http://dx.doi.org/10.1186/1471-2334-11-324
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