Immunocompromised conditions give tuberculosis a new dimension, with the emergence of disseminated or multifocal forms. Relatively frequent localizations affect both young adults and the elderly. The prognosis is poor, with mortality remaining high.
This is a retrospective study of 30 cases of multifocal tuberculosis in patients hospitalized from January 2017 to April 2025 at the respiratory diseases department of CHU Ibn Rochd in Casablanca.
The mean age was 31 years. There were 26 men and 4 women. A history of pulmonary tuberculosis and tuberculosis infection were found in 30% and 41.5% of cases, respectively. Tuberculosis affected two organs in the majority of cases (25 cases), three organs in 4 cases, and four organs in 1 case. HIV-immunocompromised patients accounted for 48% of cases. Diagnosis of tuberculosis was certain in 90% of cases. Bacilloscopy was positive in 45% of cases, and GenXpert in pleural fluid and sputum was positive in 51% and 53.5% of cases, respectively, isolating rifampicin-susceptible M. tuberculosis. Patients were treated according to tuberculosis category, as recommended by Morocco’s national tuberculosis control program. Short-term outcome was favorable in 21 cases. Death occurred in 9 cases (30%).
Multifocal tuberculosis is often perceived as the prerogative of immunocompromised subjects. It is a preoccupation of respiratory departments in tuberculosis-endemic countries. It remains a serious disease, with a high mortality rate. It is therefore essential to identify the initial infection.
