Tuberculosis: Diagnosed and Undiagnosed as a Cause of Death

Abstract

Aims and Objectives: This study has been conducted to find out the frequency of tuberculosis, histopathological pattern analysis of tuberculosis along with associated non-neoplastic changes and there role in the cause of death.
 Methodology: A retrospective cross-sectional study is done based on a Histomorphological evaluation of 23 cases diagnosed at Department of Pathology, tertiary care hospital of south Gujarat from January 2017 to December 2017. We received the gross specimen of the lungs, heart, liver, kidney, spleen, and brain for post-mortem examination in all autopsy cases. We did gross pathological and histopathological analysis of all the autopsy cases sent for histopathology over a period of one year.
 Results: In the present study out of 656 autopsy cases, 23 cases (3.5 %) were of granulomatous inflammation. Mean age of diagnosis was found to be 38 years. Males (65.2%) were more affected than females. Tuberculosis was diagnosed in only 21.7 % of total 23 cases before death. Findings were found in the lung in all cases while spread to the liver, spleen, kidney, and brain was also observed. Zeihl Neelson stain showing the presence of Acid Fast Bacilli confirms the diagnosis of tuberculous inflammation in 91% of cases.
 Conclusion: Tuberculosis is not an uncommon finding at autopsy. The lack of diagnosis pre mortem might be attributable to either the presence of social stigma in some parts of the world that dissuades people from seeking timely medical assistance, or non-typical presentations of tuberculosis cases. Indeed, even autopsies potentially have a role in helping improve community health services.