Death in notified cases of tuberculosis in Edinburgh: 1983-1992

Between 1983-1992, 730 cases of tuberculosis were notified in the Edinburgh area (population 6 x 10(5)). A review of available records identified 79 deaths (10.9% of all notifications). Thirty-seven patients (5.1%) died in the year following notification, 14 of these (five females, nine males; median age 71 years) due to tuberculosis. Five of these 14 deaths occurred within 7 days of starting chemotherapy and three deaths were due to miliary disease. Of 41 deaths (58%) before notification, 29 (19 females, 10 males; median age 77 years) were due to tuberculosis (autopsy rate 27/29) and 13 of these 29 deaths, all autopsied, were due to cryptic miliary disease. These findings reinforce continuing concerns about failure to diagnose tuberculosis, particularly cryptic miliary disease, in life.