Document 0885
 DOCN  M9460885
 TI    Effect of immunosuppressive therapy on the clinical presentation and
       outcome of tuberculosis.
 DT    9404
 AU    Skogberg K; Ruutu P; Tukiainen P; Valtonen V; Department of Bacteriology
       and Immunology, University of; Helsinki, Finland.
 SO    Clin Infect Dis. 1993 Dec;17(6):1012-7. Unique Identifier : AIDSLINE
       MED/94154099
 AB    A total of 177 tuberculosis cases of individuals not infected with human
       immunodeficiency virus diagnosed during the years 1984-1990 at the
       Helsinki University Central Hospital were reviewed retrospectively to
       compare the clinical presentation of tuberculosis in patients
       immunocompromised because of treatment (n = 35) with patients with other
       underlying conditions (n = 60) and with those without known predisposing
       factors (n = 82). In immunosuppressed patients compared with other
       patients, tuberculosis was more frequently disseminated (40% vs. 12%, P
       < 0.001), lung infiltrations were more often miliary (44% vs. 13%, P <
       0.001), and the sputum smears were less often positive (30% vs. 62%, P <
       0.05). In addition, the age-adjusted odds ratio for the risk of dying
       was higher among immunosuppressed patients than among the two other
       groups. The low rate of positive sputum smears and the high rate of
       atypical presentation and mortality stress the importance of a high
       index of suspicion and early institution of empirical antituberculosis
       therapy in immunosuppressed patients.
 DE    Adult  Aged  Aged, 80 and over  Antitubercular Agents/THERAPEUTIC USE
       Finland/EPIDEMIOLOGY  Human  Immunity, Cellular  Immunocompromised Host
       Immunosuppressive Agents/*ADVERSE EFFECTS  Middle Age  Odds Ratio
       Retrospective Studies  Support, Non-U.S. Gov't  Tuberculosis/DRUG
       THERAPY/*ETIOLOGY/MORTALITY  JOURNAL ARTICLE

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