[Extrapulmonary tuberculosis--an infection of concern in most clinical settings]

In a retrospective study at the Department for Infectious Diseases at Huddinge Hospital, 57 patients with extrapulmonary tuberculosis were identified from 1992 to 1997. Two categories of patients were found: young persons born abroad (the largest group) and elderly persons born in Sweden. Most patients showed a positive PPD, and the diagnosis was verified through bacteriological culture in 42/51 (82 per cent). Patients had sought help in a number of different clinical settings. Only four patients were shown to have resistant strains. This study demonstrates the difficulties inherent in the diagnostic process, with a long interval between appearance of symptoms to start of treatment: median 8 weeks but with a wide range. For one quarter of the patients, data sufficient to warrant conclusions regarding completed treatments are lacking. Efforts to increase knowledge on the part of medical personnel, compliance on the part of patients, and improvements in follow-up are essential in order to halt the spread of tuberculosis, to reduce morbidity and to prevent the development of resistance.