Page 96 - Livre électronique des Rencontres Franco-Tunisiennes de Pneumologie 2019

P58. PREDICTIVE FACTORS OF MULTIFOCAL TUBERCULOSIS

H. GHARSALLI1, M. ATTIA2, R. ZORAI1, I. SAHNOUN1, I. KARRAT 1, E. MHIRI3, S. MAALEJ1, H.
NAJI2, L. DOUIK ELGHARBI

1- PNEUMOLOGY DEPARTEMENT D, ABDERRAHMEN MAMI HOSPITAL, ARIANA, TUNISIA 2- RADIOLOGY DEPARTMENT,
ABDERRAHMEN MAMI HOSPITAL, ARIANA, TUNISIA 3- BACTERIOLOGY DEPARTMENT, ABDERRAHMEN MAMI HOSPITAL,
ARIANA, TUNISIA

Introduction: Multifocal tuberculosis (MT) is defined as the presence of lesions affecting at least
two extrapulmonary sites, with or without pulmonary involvement. It is a rare but dangerous form
of tuberculosis. Knowing its predictive factors can help in early diagnosis and treatment of this
entity.

Aim: To identify the predictive factors of MT.

Methods: This retrospective study was conducted between January 2010 and December 2016 and
included 154 patients with extrapulmonary tuberculosis . The patients' records were reviewed to
identify those with MT.
Results: A MT was diagnosed in 41 patients (27%). Male to female ratio was 1/7 and the mean age
was 42 years. A history of pulmonary tuberculosis was reported by 2 patients (5%). Factors
compromising immune system were observed in 11 patients (27%): diabetes (7 cases), anemia (4
cases), auto-immune disease (2 cases), cancer treatment (1 case), kidney failure (1 case) and chronic
hepatitis with cirrhosis (1case). Diagnosis delay was 137+/-182 days. The association with
pulmonary tuberculosis was observed in 51% and with miliary tuberculosis in 19.5%. Four
extrapulmonary sites were observed in 10% of cases and 3 sites in 25% of cases. MT had been
significantly correlated with a long delay of diagnosis (p=0.014), an association with pulmonary
tuberculosis (p=0.04) or miliary tuberculosis (p=0.01), anemia (p=0.006) and tachycardia (p=0.014).
Mean duration of anti-tuberculosis treatment was 10 months. Evolution was marked by relapse in
2 patients (5%).
Conclusion: In our study, predictive factors of MT were long delay of diagnosis, the association with
pulmonary tuberculosis or miliary tuberculosis, anemia and tachycardia.

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