Basic and Descriptive Spectrum of Tuberculosis in a Large Cohort of Hospitalized Patients

After 143 years from the discovery of Koch bacillus, the natural history of tuberculosis (TB) is characterized by heterogeneity and gaps of staging defining. The aim of the study consists in assessing the prevalence and characteristics of TB stages, from infection to disease, from acute to chronic disease, among inpatients of Constanta Clinical Pneumophthisiology Hospital. A cross sectional 8-year study, performed, from January 2017 to March 2025, among 630 inpatients, mean aged 58.23 years+/-13.812 std dev, mostly men (n=436; 69.2%) and smokers (n=414; 65.71%), enrolled with a positive diagnosis of TB infection (75 cases, based on positive QuantiFERON TB Gold Plus, 4% progressive forms), or disease (424 infectious, 410 new cases and 178 relapses, 35 multi drug resistant, 17 with mono or poly drug resistance). Subclinical TB was significantly more infectiousness than clinical forms (p=0.000). Active TB disease is characterized by delayed diagnosis (58.57%) and advanced extensive cavitary lesions (73.17%). Post treated lung TB disease (PTLD) occurred in 74.91% of cases, after a mean interval of almost 17 years (205.68 months+/-214.00 std dev), calculating from the first episode of treated TB disease. TB mortality rate was 16.66%o. In conclusion, landscaping tuberculosis' new stages is very complex and challenging. TB infection and subclinical TB are intricated through progressive forms of infection. PTLD must be considered a part of the basic triangle of TB spectrum, standing near infection and active disease, states in a continuous dynamic relation, overlapping through reinfections and relapses, causing PTLD and death.