Mycobacterium tuberculosis inducing disseminated intravascular coagulation
Journal
Thrombosis and Haemostasis
Journal Volume
93
Journal Issue
4
Pages
729-734
Date Issued
2005
Author(s)
Abstract
Disseminated intravascular coagulation (DIC) can develop infrequently in patients with tuberculosis and has a very high mortality rate. We conducted a retrospective study to evaluate the incidence of tuberculosis-induced DIC and to investigate the clinical manifestation, outcome, and prognostic factors of such patients. From January 2002 to December 2003, all cultureproven tuberculosis patients who developed DIC before starting anti-tuberculosis treatments were selected for this study. Patients who had other clinical conditions or were infected by other pathogens that may have been responsible for their DIC were excluded. Survival analysis was performed for each variable with possible prognostic significance. Our results showed that 27 (3.2%) out of the 833 patients with culture-proven tuberculosis had tuberculosis-induced DIC with a mortality rate of 63.0%. The most common clinical manifestations were fever (63.0%) and multiple patches of pulmonary consolidation (59.3%). Seven (25.9%) patients had disseminated tuberculosis. Twelve (44.4%) developed acute respiratory distress syndrome and three (11.1%) were associated with hemophagocytosis. Twenty-four (88.9%) patients had findings that were unusual for an acute bacterial infection, such as positive acid-fast smear, miliary pulmonary lesions, lymphocytotic exudative pleural effusion, and mediastinal lymphadenopathy. Early anti-tuberculosis treatment significantly improved survival. In conclusion, tuberculosis can cause DIC. Patients with non-miliary, non-disseminated tuberculosis could also develop the rare clinical manifestation. Since the prognosis was very poor in patients not treated at an early stage, a high index of suspicion is required, especially in those with clinical findings suggestive of tuberculosis. ? 2005 Schattauer GmbH, Stuttgart.
SDGs
Other Subjects
fibrinogen; tuberculostatic agent; acid fast bacterium; adult; adult respiratory distress syndrome; aged; article; bacterial infection; bacterium culture; clinical feature; controlled study; disease association; disseminated intravascular clotting; erythrophagocytosis; female; fever; fibrinolysis; human; incidence; Kaplan Meier method; lymphadenopathy; major clinical study; male; mediastinum lymph node; miliary tuberculosis; mortality; Mycobacterium tuberculosis; pleura effusion; priority journal; prognosis; retrospective study; smear; survival; Taiwan; thrombocyte count; tuberculosis; Adult; Aged; Aged, 80 and over; Bone Marrow Examination; Disseminated Intravascular Coagulation; Female; Humans; Incidence; Male; Middle Aged; Mycobacterium tuberculosis; Retrospective Studies; Risk Factors; Survival Analysis; Treatment Outcome; Tuberculosis
Type
journal article