DOI: 10.36347/sasjm.2023.v09i04.008

Pages: 269-276

Introduction: Tuberculosis is a cosmopolitan infection disease caused by mycobacteria of the tuberculosis complex. It is a major public health problem. Acute forms of pulmonary tuberculosis are potentially lethal. The objective of this study is to determine the epidemiological, clinical, and evolving profile of patients with acute forms of pulmonary tuberculosis. Material and Methods: We reported a case series conducted at the pneumology department of CHU Mohamed VI in Marrakech. All cases of acute tuberculosis bacteriologically confirmed were included in the study. Results: We collected 33 cases during this period. A male predominance was noted in 61% of cases. A history of pulmonary tuberculosis was noted in 5 cases (15.2%). A field of immunosuppression was found in 8 patients (24.2%) including 6 cases of diabetes and 2 cases of HIV seropositivity. The main symptoms were dyspnea in 18 cases (54.5%), cough in 16 cases (48%) and hemoptysis in 4 cases (12%). The chest X-ray objectified an aspect of miliary in 26 cases (78.7%), an aspect of bronchopneumonia in 4 cases (12%) and caseous pneumonia in 3 patients (9%). In the cases of miliary, the diagnosis was made by a compatible clinical and radiological signs in 20 cases (77%) and by bacteriological confirmation through direct examination of expectorations in 6 cases (23%). As for pneumonia and bronchopneumonia, bacteriological confirmation was obtained through direct examination of expectorations in 5 cases (71.4%) and through molecular biology (GenXpert) in the other cases (28.6%). The anti-bacillary treatment was started urgently, according to the national anti-bacillary program. Corticosteroid therapy at a dose of 1 mg/kg/day; was administered to 10 patients presenting with dyspneic miliaria. Side effects of anti-bacillary treatment were dominated by drug-induced hepatitis in its cytolytic form. 2 patients died (6%) following severe acute respiratory failure associated with pulmonary embolism in 1 case. ........