A subset of clinical status of pulmonary tuberculosis in Southern Taiwan.

The aims of this study were to present the clinical status of pulmonary tuberculosis in Southern Taiwan and to analyze the reasons for failure of antituberculosis treatment in order to achieve a higher rate of success after treatment. Two hundred and senventeen adult patients, aged 15 to 90 years old who presented to the Chest Division, Kaohsiung Medical University Hospital from 1999 to 2002 with a diagnosis of Pulmonary Tuberculosis, were retrospectively studied. We compared the rate of recurrence of pulmonary tuberculosis by dividing the cases into 2 groups: those who completed treatment and those who did not. We also determined the age distributions for when initial diagnosis of pulmonary tuberculosis was made among these 217 cases. In 90 culture proven cases, antituberculosis drug susceptibility was tested to determine the rate of drug resistance. We also assessed the reasons for failure of treatment. Age distribution analysis showed that initial infection began at a young age, was widely spread, and occurred regardless of age. There were 116 cases that completed antituberculosis treatment and 101 cases that did not. Of the 116 cases, only 16 relapsed, whereas 79 of the 101 cases relapsed. In cases where completely treated patients relapsed, the period before recurrence was indefinite. Most of the cases of incompletely treated patients relapsed earlier. In the 90 culture proven cases in which antituberculosis drug susceptibility was tested, 39 patients showed resistance to at least one drug, 9 patients were resistant to only one drug, 9 patients were resistant to two drugs and 21 patients were resistant to more than 3 drugs. The common reasons for failure of treatments were: 1) poor patient compliance to medication: 50 cases, 2) multiple drug resistance: 30 cases, 3) delayed treatment: 19 cases. Some cases included a combination of the above.