Authors
Patricia Yvonne Maciel Pinheiro, Renata Artimos de Oliveira Vianna, Laura da Cunha Ferreira, Billy McBenedict, Solange Artimos de Oliveira, Ezequias Batista Martins
Published in
Acta tropica. Pages 108406. Nov 09, 2026. Epub Nov 09, 2026.
Abstract
Tuberculosis (TB) remains a serious public health problem worldwide. Extrapulmonary TB results from hematogenous dissemination or the extension of the infection to an adjacent organ by contiguity. This retrospective observational study analyzed TB admissions included in a historical institutional grouping comprising extrapulmonary presentations, miliary TB, and combined pulmonary and lymph node TB at a Brazilian university referral hospital between 1965 and 2024. Demographic, clinical, HIV co-infection, and outcome data were extracted from a prospectively maintained institutional database. Patients were compared between the pre-1990 and post-1990 periods using Pearson's χ² test to evaluate temporal changes in epidemiological characteristics. Among 15,601 hospitalizations, 792 admissions involved a diagnosis of TB, including 306 (38.6%) in the historical study group comprising extrapulmonary presentations, miliary TB, and combined pulmonary and lymph node TB. Meningoencephalitic tuberculosis was the most frequent presentation (44.4%) and showed the highest case fatality rate (30.1%), predominantly affecting young children. Among admissions in the historical study group, the proportion of meningoencephalitic TB was lower after 1990 (73.5% versus 22.4%; p<0.001), whereas the proportions of lymph node, pleural, and combined pulmonary and lymph node TB were higher. By decade, meningoencephalitic TB decreased from 51 cases (15.06 per 1,000 departmental admissions) in 1965-1974 to 3 cases (1.26 per 1,000) in 2015-2024. In the unadjusted comparison, in-hospital case fatality was 34.8% before 1990 and 5.7% thereafter (p<0.001). Within meningoencephalitic TB, case fatality was 36.1% (35/97) before 1990 and 15.4% (6/39) thereafter. These findings describe changes in the clinical distribution and admission-based frequency of TB presentations within a single department. Changes in referral, admission practices, and diagnostic capacity may have contributed, precluding inference about population incidence or attribution to specific causes.
PMID:
43003215
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.
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