Abstract
A total of 80 adult patients aged 34 +/- 9.8 years with tuberculosis (TB) was studied at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, between January 1988 and June 1993. They included 73 cases of pulmonary TB and seven of miliary tuberculosis (MTB). Underlying disease preceding TB was present in 39% (31/80) of patients. About half of these patients presented with clinical features suggestive of TB. Upper lung field infiltrates (ULFI) indicating TB were observed in 57.5% of patients. In addition, lower lung field infiltrates (LLFI) and miliary shadowing were observed in 17.5% and 8.7% of cases, respectively. The organism was detected from expectorated sputum specimens in 70% of cases. Of the specimens obtained by flexible fibreoptic bronchoscopy, 62% were positive by AFB smear and culture. In 10% of patients, the diagnosis of TB was delayed or missed. Drug-induced adverse effects were observed in only two patients. Three patients died, two from MTB and one from pulmonary TB. Elderly (greater than or equal to 60 years) patients more commonly had LLFI, miliary shadowing, hypoxaemia, and high mortality. In addition, they also had high ESR, thrombocytopenia, elevated AST and hypoalbuminaemia. We conclude that only about half of our adult patients presented with typical clinical, radiological features and a proportion of them also showed LLFI and miliary shadowing. However, significant differences were observed between these patients and the elderly.