If tuberculosis is not detected in patients being treated for cancer, it can easily spread to other hospitalized cancer patients, a new report shows.

A failure to recognize that two patients with leukemia also had TB led to 19 other individuals at four facilities becoming infected, according to federal and Illinois state health officials.

They say screening cancer patients for TB at the outset could prevent this kind of thing happening.

“Although delays in TB diagnosis among patients with malignancies are understandable in light of the clinical complexities, such delays are costly and can have fatal consequences,” Dr. Joseph L. Malone from the Centers for Disease Control and Prevention in Atlanta and associates write in the medical journal Cancer.

The team reports that after the two patients with leukemia developed obvious TB in 2002, within a year three more patients came down with the same condition at the centers where the original patients had received treatment.

This prompted an investigation. Tuberculin skin testing showed that, all told, five hospital workers and 14 patients or visitors at the four facilities had picked up the infection.

The fact that both of the original patients were U.S.-born, white males may have contributed to the delay in diagnosing TB, according to the investigators. They note that the number of TB cases in the U.S. in 2002 were at an all-time low and most involved foreign-born or African-Americans patients.

SOURCE: Cancer, December 15, 2004.