The real burden of tuberculosis: Hidden cases diagnosed on autopsy at a tertiary care center of India.

Introduction: Developing nations have a huge burden of tuberculosis (TB), because of which many cases are undetected and diagnosed only on autopsies. The purpose of this study was to find these cases in a series of consecutive autopsies conducted at a tertiary care centers.

Materials And Methods: This retrospective study of 7-year duration from 2014 to 2020 consisted of reviewing 767 autopsies. The records of cases where a diagnosis of TB were established on histopathology were noted and evaluated.

Results: Of 767 autopsies, TB was the diagnosis on histopathology in 72 cases. Of the 72 cases, 53 cases were undiagnosed antemortem and incidentally detected on autopsy. The study showed a male predominance with a 1.52:1 male-to-female ratio. The most common age group involved was the second decade. The study constitutes 26 cases of isolated pulmonary TB, 23 cases of disseminated TB, three cases of solitary renal TB, and one case of hepatic TB. The liver was the most commonly involved organ along with the lung in cases of disseminated TB, followed by the spleen, kidney, pancreas, intestine, brain, and heart.

Discussion: Epidemiology and research on TB may be affected by these hidden cases which are unraveled incidentally on autopsy. These cases must always be reported and brought to the attention of clinicians for nation's better public health.