The management of thirty immunocompromised patients with tuberculosis

Between 1978 and 1981, 30 of 870 bacteriologically confirmed cases of tuberculosis occurred in immunocompromised hosts. One year after the diagnosis, 11 patients were dead, only 2 of them of tuberculosis. In the other 19 patients, the course of tuberculosis under standard chemotherapy was the same as in nonimmunocompromised hosts. Among the 24 patients still alive more than 2 months after the diagnosis of tuberculosis, the treatment of the underlying disease was changed in 14 patients to avoid worsening of the course of tuberculosis; 5 patients died and 4 kidney transplant carriers rejected their transplants. The treatment of the underlying disease was not changed in 10 patients: all of these remained alive 1 yr later, and 2 were kidney transplant carriers who did not reject their transplants. We conclude that the clinical response of the immunocompromised tuberculous host was good and that treatment of the underlying disease should not be modified.