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High mortality due to gastrointestinal TB in HIV and non-HIV patients

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BACKGROUND: Due to the reported low incidence of gastrointestinal TB, there is a lack of data related to the prognosis, risk factors and frequency of resistant TB in this subgroup of patients.

OBJECTIVE: To report the clinical presentation, diagnostic methods, treatment and outcomes in gastrointestinal TB.

METHODS: We prospectively studied the demographic, clinical, and paraclinical data of all consecutive gastrointestinal TB inpatients over an 8-year period.

RESULTS: We identified gastrointestinal TB in 28 (3.5%) out of 799 inpatients with TB infection. Seven patients (25%) were HIV-positive. Overall mortality was 35.7%, with the combined variable of haemoglobin <12 g/dL and albumin <2.8 g/dL being independently associated with mortality (OR 25.7, 95% CI 1.405–471.1, P = 0.029). No difference in the need for surgery (28.6% vs. 47.6%, P = 0.662), occurrence of septic shock (14.3 vs. 23.8%, P = 1.00) or mortality (14.3% vs. 42.9%, P = 0.364) was found between HIV and non-HIV patients.

CONCLUSION: Gastrointestinal TB was rare among TB patients in Hospital Universitario “Dr José E. González” (3.5%), but had a high mortality rate (35.7%). Clinical evolution, drug susceptibility patterns and outcomes were similar in HIV and non-HIV patients. In both groups, the combined haemoglobin and albumin variable on admission was clearly associated with mortality.

Keywords: abdominal tuberculosis, HIV; extrapulmonary tuberculosis; hospital mortality; inflammatory bowel disease

Document Type: Research Article

Affiliations: 1: Servicio de Gastroenterología, Hospital Universitario “Dr José E González”, Universidad Autónoma de Nuevo León, Monterrey, México, Escuela de Medicina y Ciencias de la Salud, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, México 2: Servicio de Gastroenterología, Hospital Universitario “Dr José E González”, Universidad Autónoma de Nuevo León, Monterrey, México 3: Servicio de Anatomía Patológica y Citopatología, Monterrey, México 4: Departamento de Radiología e Imagen, Monterrey, México 5: Escuela de Medicina y Ciencias de la Salud, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, México 6: CIPTIR (Centro de Investigación, Prevención y Tratamiento de Infecciones Respiratorias), Hospital Universitario “Dr José E. González”, Universidad Autónoma de Nuevo León, Monterrey, México

Publication date: April 1, 2022

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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