[A study on far-advanced cavitary pulmonary tuberculosis cases]

Abstract

In cases with far-advanced cavitary pulmonary tuberculosis, the most serious lesions according to the chest X-ray classification by the Japanese Society of Tuberculosis (b I 3), their prognosis is believed to be poor due to their emaciated general conditions, and a retrospective clinical study was made on these cases admitted to our hospital. The subjects consisted of 95 cases, and among them 87 were male and 8 were female, and their mean age was 49.5 +/- 13.0 years. Eighty four cases were detected by symptomatic visits to clinics, 10 cases during their treatment for other diseases, and 1 case was discovered accidentally. Sputum examination for acid fast bacilli was all smear positive. As to their social background, the majority were occupied by socially vulnerable groups; 31 cases (32.6%) were jobless on admission, 24 cases (25.3%) were day laborers, and 25 cases (26.3%) were receiving poor relief. Regarding their general condition on admission, 40 cases were very serious and they could not stand by themselves, and their nutritional conditions were poor, and 19 cases (20%) died during hospitalization. All of them were male, and they were found by symptomatic visit to clinics. The period from hospital admission to death was short, the average was 35.0 +/- 39.8 days, and the median was 11.0 days. Among 84 patients detected by symptomatic visit, the patient's delay was 5.5 +/- 5.0 months, while the doctor's delay was 0.3 +/- 0.9 months. Major cause of late detection at advanced stage of these cases was patient's delay which caused poor prognosis of these cases, and various measures to shorten the delay in case-detection must be taken.