TUBERCULOSIS IN ADULTS (18-59 YEARS) IN SAUDI-ARABIA - EXPERIENCE AT A UNIVERSITY HOSPITAL

A total of 80 adult patients aged 34 +/- 9.8 years with tuberculosis ( TB) was studied at King Khalid University Hospital (KKUH), Riyadh, Sau di Arabia, between January 1988 and June 1993. They included 73 cases of pulmonary TB and seven of miliary tuberculosis (MTB). Underlying di sease preceding TB was present in 39% (31/80) of patients. About half of these patients presented with clinical features suggestive of TB. U pper lung field infiltrates (ULFI) indicating TB were observed in 57.5 % of patients. In addition, lower lung field infiltrates (LLFI) and mi liary 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 bronchoscop y, 62% were positive by AFB smear and culture. In 10% of patients, the diagnosis of TB was delayed or missed. Drug-induced adverse effects w ere observed in only two patients. Three patients died, two from MTB a nd one from pulmonary TB. Elderly (greater than or equal to 60 years) patients more commonly had LLFI, miliary shadowing, hypoxaemia, and hi gh mortality. In addition, they also had high ESR, thrombocytopenia, e levated AST and hypoalbuminaemia. We conclude that only about half of our adult patients presented with typical clinical, radiological featu res and a proportion of them also showed LLFI and miliary shadowing. H owever, significant differences were observed between these patients a nd the elderly.