Tuberculosis in a general hospital 1987

Tuberculosis (TB) was diagnosed in 15 patients admitted during a 1-year period starting November 1986. 4 had been treated with corticosteroids prior to diagnosis. Most were admitted with exacerbation of chronic obstructive pulmonary disease, acute respiratory failure and prolonged fever. The most frequent X-ray findings were infiltrates in the lower lobes and the middle lobe. Sputum cultures were positive for TB in only 4 patients, while culture of gastric aspirates was diagnostic in 9. Our findings point to an increase in the detection of TB in the Negev. It must be ruled out in patients with diabetes, those undergoing prolonged corticosteroid therapy and in Bedouin and Yemenite patients in whom there is a greater incidence of the disease. Culture of gastric aspirates should be included in the workup for TB.