Background. In the United States, the proportion of patients with extrapulmonary tuberculosis (EPTB) hasincreased relative to cases of pulmonary tuberculosis. Patients with central nervous system (CNS)/meningeal anddisseminated EPTB and those with human immunodeficiency virus (HIV)/AIDS have increased mortality. Thepurpose of our study was to determine risk factors associated with particular types of EPTB.Methods. We retrospectively reviewed 320 cases of EPTB from 1995–2007 at a single urban US public hospital.Medical records were reviewed to determine site of EPTB and patient demographic and clinical characteristics.Multivariable logistic regression analyses were performed to determine independent associations between patientcharacteristics and site of disease.Results. Patients were predominantly male (67%), African American (82%), and US-born (76%). Mean agewas 40 years (range 18–89). The most common sites of EPTB were lymphatic (28%), disseminated (23%), andCNS/meningeal (22%) disease. One hundred fifty-four (48.1%) were HIV-infected, 40% had concomitant pulmonarytuberculosis, and 14.7% died within 12 months of EPTB diagnosis. Multivariable analysis demonstratedthat HIV-infected patients were less likely to have pleural (adjusted odds ratio [AOR] 0.3; 95% confidence interval[CI] .2, .6) as site of EPTB disease than HIV-uninfected patients. Among patients with EPTB and HIV-infection,patients with CD4 lymphocyte cell count <100 were more likely to have severe forms of EPTB (CNS/meningealand/or disseminated) (AOR 1.6; 95% CI, 1.0, 2.4).Conclusions. Among patients hospitalized with EPTB, patients coinfected with HIV and low CD4 countswere more likely to have CNS/meningeal and disseminated disease. Care for similar patients should include considerationof these forms of EPTB since they carry a high risk of death
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