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[Active tuberculosis unsuspected until autopsy]

A Andrion, R Bona, F Mollo

    Minerva Medica
    |January 21, 1981
    PubMed
    Summary
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    Autopsies revealed active tuberculosis in 1.9% of natural deaths. Most cases were undiagnosed antemortem, highlighting challenges in recognizing this complex disease.

    Area of Science:

    • Pathology
    • Infectious Diseases

    Context:

    • Retrospective analysis of 3195 necropsies from 1969-1978 at "S. Giovanni" Hospital, Turin.
    • Focus on the prevalence and diagnostic challenges of active tuberculosis in natural deaths.

    Purpose:

    • To determine the prevalence of active tuberculosis (TB) in autopsy cases.
    • To evaluate the diagnostic accuracy of clinical assessments for active TB.
    • To identify factors contributing to missed antemortem diagnoses.

    Summary:

    • Active tuberculosis was identified in 61 (1.9%) of 3195 necropsies.
    • In 60 cases with clinical history, 42 (70%) were diagnosed solely during autopsy, particularly in elderly patients.
    • Diagnostic investigations like acid-fast bacilli testing and chest X-rays were underutilized in undiagnosed cases.

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    Impact:

    • Underscores the difficulties in clinical diagnosis of active tuberculosis.
    • Suggests improved recognition is possible with heightened clinical suspicion for this polymorphic disease.
    • Emphasizes the need for comprehensive clinical, laboratory, and radiological evaluations.