[Active tuberculosis unsuspected until autopsy]

A series of 3195 necropsies performed in cases of natural death at the "S. Giovanni" Hospital in Turin, and covering the years 1969-1978, was studied for the prevalence of active tuberculosis. Active tuberculosis was found in 61 cases (1,9%); in 60 a complete clinical history was available. Forty-two out of these 60 cases (70%) were diagnosed only at autopsy, with higher frequency in the old patients. In the 42 patients with undiagnosed active tuberculosis, the acid fast bacilli resulted to have been searched for only in 3 cases, and a chest-film was recorded in 23 cases; in 27 cases of this group, the period between the admission and the death was longer than 8 days (mean 29 days). The clinical diagnosis of active tuberculosis displays intrinsic difficulties; however it must be stressed that an higher proportion of cases could be recognized if one keeps in mind the possibility of this polymorphic disease, so that adequate clinical, laboratory and x-ray investigations should carried out.