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Extrapulmonary tuberculosis. A review.

N C Elder1

  • 1Department of Family and Community Medicine, Oregon Health Sciences University, Portland.

Archives of Family Medicine
|September 1, 1992
PubMed
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Extrapulmonary tuberculosis (TB) is increasingly diagnosed in individuals with human immunodeficiency virus (HIV). Early diagnosis and prolonged treatment are crucial for managing this challenging condition, especially in immunocompromised patients.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Immunology

Background:

  • Rising incidence of tuberculosis (TB) linked to human immunodeficiency virus (HIV) infection.
  • Tuberculosis can disseminate beyond the lungs, affecting nearly every organ system.
  • Extrapulmonary TB incidence has outpaced pulmonary TB, particularly since 1984.

Purpose of the Study:

  • To highlight the diagnostic and treatment challenges of extrapulmonary tuberculosis.
  • To emphasize the increased risk and diagnostic difficulties in immunocompromised individuals, especially those with HIV.
  • To underscore the need for a high index of suspicion for timely diagnosis and management.

Main Methods:

  • Review of clinical manifestations and diagnostic criteria for extrapulmonary tuberculosis.

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  • Discussion of diagnostic tools including skin tests, chest roentgenograms, and microbiological examination.
  • Analysis of treatment strategies, including standard antitubercular medications and duration of therapy.

    • Main Results:

    • Extrapulmonary tuberculosis is a diagnostic criterion for acquired immunodeficiency syndrome (AIDS).
    • Clinical presentations are often nonspecific, leading to delayed diagnosis, except in emergencies like miliary or meningeal TB.
    • Microscopic examination and culture of infected tissues/fluids are essential for definitive diagnosis.

    Conclusions:

    • Extrapulmonary tuberculosis poses a significant and growing public health challenge, particularly with increasing HIV prevalence.
    • Standard antitubercular treatment is effective, but patients with HIV require longer treatment durations.
    • A high index of suspicion is critical for prompt diagnosis and effective management to preserve patient health.