ABSTRACT
SETTING: A tuberculosis (TB) referral hospital in the state of Bahia, north-eastern Brazil. OBJECTIVE: To evaluate the association between serum albumin at admission and in-hospital deaths due to TB. DESIGN: A prospective cohort study of 373 patients hospitalised with TB. Samples were systematically collected from all patients at hospital admission for measurement of serum albumin levels. In-hospital death was the study endpoint. Univariate analysis was used to evaluate the association between serum albumin at admission and mortality from TB, and multivariate logistic regression was used to adjust for potential confounding variables. RESULTS: The average age of the 373 patients was 41.1 years (+/-15.2); 77.2% (288/373) were male; 45 eventually died in hospital (in-hospital death rate 12.1%, 95%CI 9.0-15.7). Multivariate analysis showed that the presence of low serum albumin levels (< or =2.7 g/dl) was strongly and independently associated with in-hospital death due to TB (adjusted OR 3.38, 95%CI 1.51-7.59; P = 0.001), even after adjusting for potentially confounding variables identified in the univariate analysis (age, comorbidities, TB-human immunodeficiency virus [HIV] coinfection and history of previous default from treatment). CONCLUSION: Our results highlight the importance of measuring serum albumin levels at admission to hospital as an indicator of the prognosis for patients hospitalised with TB.
Subject(s)
Hospital Mortality , Serum Albumin/analysis , Tuberculosis, Pulmonary/blood , Tuberculosis, Pulmonary/mortality , Adult , Brazil/epidemiology , Cohort Studies , Female , HIV Infections/blood , HIV Infections/complications , Humans , Male , Middle Aged , Multivariate Analysis , Patient Admission , Prognosis , Tuberculosis, Pulmonary/complicationsABSTRACT
Central nervous system involvement by tuberculosis presents two main types: tuberculosis meningitis or tuberculoma. This second condition has nowadays ideal conditions for development. We report three patients who developed paradoxical brain tuberculosis expansive lesion during the use of tuberculostatic drugs. The cases point out the importance of tomography follow up of patients who present neurological signs in the course of treatment for tuberculosis. The first two patients presented onset of the a neurological symptoms, associated with lung tuberculosis. The third patient previously had tuberculous meningitis. Computerized tomography was used to follow up these patients. Tuberculostatic and corticoid drugs were used for treatment.
Subject(s)
Antitubercular Agents/therapeutic use , Brain Diseases/microbiology , Central Nervous System Diseases/microbiology , Tuberculoma, Intracranial/drug therapy , Adult , Brain Diseases/diagnostic imaging , Central Nervous System Diseases/diagnostic imaging , Female , Humans , Male , Radiography , Tuberculoma, Intracranial/diagnostic imaging , Tuberculosis, Meningeal/complications , Tuberculosis, Meningeal/drug therapy , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/drug therapyABSTRACT
We describe three cases of adiaspiromycosis with acute clinical manifestations and diffuse lung lesions. Sixteen previously reported similar cases are also reviewed. The best designation for this syndrome is acute pulmonary adiaspiromycosis.
