CLINICAL DIFFERENCES BETWEEN PULMONARY END EXTRAPULMONARY TUBERCULOSIS - A 5-YEAR RETROSPECTIVE STUDY

This article describes the clinical, epidemiologic, laboratory, and tr eatment characteristics of pulmonary tuberculosis (PTB) and extrapulmo nary tuberculosis (EPTB) in Eastern North Carolina, a primarily rural area. The database was obtained for 1988-1992 from the University Medi cal Center of Eastern North Carolina-Pitt County and East Carolina Uni versity School of Medicine (the tertiary care referral center for this region). One hundred thirty-eight culture-positive patients were enro lled in the study; 56% were PTB and 44% were EPTB. African-American ma les constituted 59% of the population. Sixty-nine percent of the patie nt base were uninsured. There was a bimodal age distribution of <40 an d >60 years of age. Factors associated with PTB (reported as odds rati os) were white males (2.5), diabetes mellitus (5.4), and cancer (5.1). Factors associated with EPTB (reported as odds ratios) were African-A merican females, positive human immunodeficiency virus (HIV) serology (8.7), low hematocrit (32.6), and elevated alkaline phosphatase (199). This study emphasizes that in the latest resurgence of tuberculosis, impoverished rural areas, which have been ignored in earlier and prese nt control efforts, are important reservoirs of disease.