Delay to Establish the Diagnosis, and the Clinical Picture, Radiologic Findings and Bacteriology Results in Pulmonary Tuberculosis

Abstract

The relationship between the delay to establish the diagnosis of tuberculous disease, and the clinical picture, radiologic findings and smear sputum tests results in smear-positive cases of TB at the Hospital Nacional Daniel Alcides Carrión - Callao, in 1996, was analized. A total of 130 patients (70 males, 30,96 ± 15,05 years-old) were studied. The Mean Delay to Establish the Diagnosis (MDED) was 60,27 ± 54,94 d, being 75,50 ± 66,38 d the largest time (patients from the ER). MDED was correlated with the following: procedence (30% from department of pneumology, 70% the remainder); type of sputum [commonest: mucous type 39,23%, Mean Time (MT) = 58,44 ± 44,95 d]; weight loss (commonest: mild < 5 kg: 48,46%, MT = 53,12 ± 42,91 d); hemoptysis (commonest: mild < 200 mL/d, 22,31%; MT = 84,81 ± 63,76 d); crackles: 73,08%, MT = 59,71 ± 54,51 d; subcrepits: 30,77%, MT = 47,00 ± 45,37 d; cavities: single 27,69%, MT = 88,83 ± 57,77 d; one-sided 31,54%, MT = 90,13 ± 67,72 d; smear-microscopy results (1+): 39,23%, MT = 66,09 ± 54,33 d, (2+): 30%, MT = 39,35 ± 33,60 d and (3+): 30,77%, MT = 73,25 ± 65,93 d. There were positive correlations between the variables in all of cases. The delay between the onset of symptoms and the diagnosis in non-treated patients was 60,27 ± 54,94 d. Clinic, radiologic and microscopic features showed a positive correlation with the MDED. Finally, we show that, in all cases, after 60 days since the onset of symptoms, there was an increase in the severity, being a preventable and predictible group.