[Tuberculosis in patients with hemoblastoses]

Examining 2321 patients admitted for various forms of hemoblastoses (HB) to the Hematology Research Center, Russian Academy of Medical Sciences, in 1990-1999 revealed active forms tuberculosis in 60 (2.6%) patients. Among them generalized tuberculosis and predominantly extrapulmonary tuberculosis were detected in 8 (10.1%) and 10 (12.7%) patients, respectively. Bacteriological and morphological studies confirmed the diagnosis only in 22 (27.8%) patients, including in 15 (22.9%) patients with pulmonary tuberculosis. In the bulk of patients [n = 51 (64.6%)], the diagnosis of tuberculosis was suspected on the basis of a complex of clinical and X-ray data and evidenced by the beneficial effect of antituberculous chemotherapy. The clinical and X-ray manifestations of tuberculosis were similar in patients with different forms of HB. They are characterized by an aptness to hematogenous dissemination of the process, by the incidence of generalized and extrapulmonary lesions involving blood-forming organs, and by the significant extent of infiltrative changes in the lung with a relatively formation of single and small decay cavities. Antituberculous chemotherapy according to the standard regimen recommended by the WHO yielded a prompt and significant effect by improving the patients' status, eliminating fever, and ceasing bacterial isolation. Deaths occurred in 6 (7.6%) patients with lifetime undiagnosed generalized tuberculosis untreated with antituberculous drugs.