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Occurrence with bacteriologically positive pulmonary tuberculosis.

M K Agarwal, P P Muthuswamy, A S Banner

    JAMA
    |November 21, 1977
    PubMed
    Summary
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    Persistent fever in pulmonary tuberculosis patients despite chemotherapy may indicate concurrent septicemia. Blood cultures are crucial for identifying bacterial infections in these cases, even without leukocytosis.

    Area of Science:

    • Infectious Diseases
    • Pulmonary Medicine
    • Microbiology

    Background:

    • Pulmonary tuberculosis (TB) management typically involves chemotherapy.
    • Fever is a common symptom of active TB.
    • Chemotherapy aims to resolve symptoms, including fever.

    Purpose of the Study:

    • To investigate the cause of persistent fever in patients with pulmonary tuberculosis undergoing chemotherapy.
    • To determine the prevalence and types of concomitant septicemia in this patient group.
    • To assess the diagnostic value of blood cultures in febrile TB patients unresponsive to treatment.

    Main Methods:

    • Retrospective analysis of ten patients with bacteriologically confirmed pulmonary tuberculosis and persistent fever.
    • Review of blood culture results for bacterial identification (Gram-positive and Gram-negative).

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  • Correlation of blood culture findings with sputum and urine cultures, and assessment of leukocytosis and radiographic signs of superinfection.

    • Main Results:

    • Fever remained unchanged by chemotherapy in all ten patients.
    • Blood cultures were positive in all ten patients: six with Gram-positive and four with Gram-negative organisms.
    • Concordant organisms were found in sputum and blood in six patients, and in urine and blood in two patients.
    • Leukocytosis and radiographic evidence of superinfection were absent.

    Conclusions:

    • Persistent fever in pulmonary tuberculosis patients treated with chemotherapy warrants investigation for concomitant septicemia.
    • Blood cultures are essential for diagnosing concurrent bloodstream infections in febrile TB patients, irrespective of leukocytosis.
    • Early identification of septicemia is critical for appropriate management and improved patient outcomes in complex TB cases.