当院における粟粒結核の臨床的検討

Abstract

Eighteen patients with miliary tuberculosis (MTB) were admitted to our hospital from 1994 to 2003. The mean age of the patients was 63.9 years (range 19-92). Past history of tuberculosis was recognized in one case. Six cases suffered from another underlying diseases, and 3 of them had been treated with corticosteroids. Smear, PCR and culture of sputum were positive for mycobacterium tuberculosis in 61%, 79% and 94% of cases, respectively. Chest computed tomography revealed diffuse micronodular shadow and diffuse infiltration in 100% and 22% of cases, respectively. The laboratory findings of 18 patients with MTB were compared with 240 patients with non-MTB who were admitted to our hospital from 1999 to 2001. Body mass index, serum total protein, albumin and peripheral blood lymphocyte count were significantly lower in MTB patients than in non-MTB patients. Five patients died during admission, 3 of them died of MTB and 2 of them died of cardiac disease. In the 3 died patients due to MTB, 2 of them had been treated with corticosteroids for fever, 2 of them had acute respiratory distress syndrome and 3 of them had disseminated intravascular coagulation. Serum total protein, albumin and platelet count were lower in the died patients due to MTB than in the living patients.