[A study on cases diagnosed as pulmonary tuberculosis after admission to the general hospital lacking tuberculosis...

We analyzed retrospectively the clinical data of 12 patients diagnosed as pulmonary tuberculosis after admission to the National Himeji Hospital during the past 5 years. Ten out of 12 patients were male and were of elder age-groups (mean age: 65.5 years, range: 32-76 years). Seven patients at first visited the department of respiratory medicine, and the remaining three patients were admitted without consulting the department of respiratory medicine before admission. Only patient had a history of pulmonary tuberculosis. Two patients were suspected of pulmonary tuberculosis on admission. Tubercle bacilli were positive sputum smear in 6 patients, sputum culture in 1, smear of bronchial washing in 4, and smear of BALF in 1. It took 12.7 days on the average from the admission to make a final diagnosis as pulmonary tuberculosis patients into a general hospital lacking TB ward were as follows: (1) As pulmonary TB was not suspected, Chest X-ray and sputum examination were not performed. (2) The admission was done due to another disease and respiratory symptoms were scarce. (3) Tuberculosis lesions on chest X-ray were harbored by pleural effusions and diffuse shadows. (4) Though pulmonary tuberculosis was suspected, a patient was admitted because of general prostration as sputum smear was negative. After admission, however, repeated sputum culture revealed positive results. (5) Pulmonary tuberculosis developed after the admission.