Diagnosis and treatment of 20 tuberculous patients who entered a community hospital.

The need for a tuberculosis control program involving physicians practicing in a community hospital was illustrated by a study of the 20 patients with proved active pulmonary tuberculosis who entered the hospital during the four years since January 1966. Thirteen patients were acutely ill and 7 were chronically ill. One patient was known to have tuberculosis on entry. In 19 others, the symptoms and radiographic findings were attributed mostly to heart failure, bronchopneumonia, or carcinoma. Diagnosis was made at necropsy in 2 cases and after segmental resection or lobectomy in 6 others. In 11 patients, Mycobacterium tuberculosis was recovered from the sputum. Antituberculous chemotherapy was started in 13 of the patients while they were in the community hospital, but 2 patients died before their disease was recognized. In 5 others, antituberculous chemotherapy was deferred until they were transferred to a tuberculosis hospital.