Miliaire Tuberculeuse Bacillifère : Aspects Épidémiologiques, Cliniques et Paracliniques à l’Hôpital Jamot de Yaoundé

RESUME Objectifs. Decrire les aspects epidemiologiques, cliniques et evolutifs de la miliaire tuberculeuse bacillifere a l’Hopital Jamot de Yaounde. Population et Methodes. Nous avons mene une etude prospective longitudinale et descriptive, du 1er janvier au 30 juin 2019 a l’Hopital Jamot de Yaounde. Nous avons inclus les patients des deux sexes, âges d’au moins 18 ans chez qui le diagnostic de miliaire tuberculeuse bacillifere avait ete pose. Les donnees epidemiologiques, cliniques, paracliniques, therapeutiques et evolutives etaient recueillies. Resultats. Au total, nous avons recrute 75 patients dont 39(52%) etaient de sexe masculin ; La moyenne d’âge etait 33,3(± 8,13) ans et la tranche d’âge la plus representee etait celle de [35-45[ ans. Les facteurs favorisant etaient l’infection au VIH (64%) et l’alcoolisme (64%). Les signes generaux etaient quasi constants. Les signes fonctionnels etaient essentiellement la toux (92%), l’expectoration (70,7%), la dyspnee (60%) et la douleur abdominale (36%). L’aspect radiologique typique de miliaire etait plus represente (64%) ; les principales images associees etaient des condensations (28,3%) et des cavernes (24,5%). Tous les patients avaient une anemie. Les localisations extrapulmonaires etaient abdominales (64%) et pleurales (40%). Sept patients ont ete perdus de vue. le taux de letalite etait de 9,3%. Conclusion. La miliaire tuberculeuse bacillifere affecte majoritairement des adultes jeunes de sexe masculin. Sa presentation clinique est dominee par les signes generaux, la toux et de nombreux symptomes extra respiratoires. L’aspect radiologique typique est le plus represente. L’anemie et l’ hyperleucocytose sont frequentes. La mortalite est elevee.ABSTRACTObjective. To describe epidemiology, clinical manifestations and outcome of bacilliferous miliary tuberculosis at Hopital Jamot in Yaounde. Population and Methods. We conducted a longitudinal prospective and descriptive study from January 1 to June 30, 2019 at Jamot Hospital in Yaounde. We included patients of both sexes, at least 18 years of age, who had been diagnosed with bacilliferousmiliary tuberculosis. We collected epidemiological, clinical, paraclinical, therapeutics and evolutive data were collected. Results We enrolled a total of 75 patients, 39 (52%) were male. The average age was 33.3 (±8.13) years and the age group [35-45[ was the most represented. The main contributing factors were HIV (64%) and alcoholism (64%). The general signs were almost constant. The main physical findings were cough (92%), sputum (70.7%), dyspnea (60%) and abdominal pain (36%). The characteristic radiological finding of miliary tuberculosis was the most present (64%); the related patterns most found were consolidation (28.3%) and cavitation (24,5%). All patients were anemic. Extrapulmonary locations were abdominal (64%) and pleural (40%). Seven patients (09.3%) were lost to follow-up. The fatality rate was 9.3%. Conclusion. Bacilliferous miliary tuberculosis affects mainly young male adults. The main clinical manifestation are general signs, cough and extra pulmonary symptoms. The typical radiological finding are most common. Anemia and hyperleukocytosis are frequent. Mortality is high.