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Related Experiment Videos

Extrapulmonary tuberculosis: an overview.

Marjorie P Golden1, Holenarasipur R Vikram

  • 1Yale University School of Medicine and Hospital of Saint Raphael, New Haven, Connecticut, USA.

American Family Physician
|November 23, 2005
PubMed
Summary
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Tuberculosis (TB) rates resurged in the 1980s with the HIV epidemic, leading to more disseminated and extrapulmonary TB. Early diagnosis and treatment are crucial, even with non-definitive tests, to manage this complex disease.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Medicine

Background:

  • The 1980s saw a resurgence of tuberculosis (TB) in the United States, concurrent with the acquired immunodeficiency syndrome (AIDS) epidemic.
  • Current TB disease patterns exhibit a higher incidence of disseminated and extrapulmonary manifestations.
  • Extrapulmonary TB commonly affects lymph nodes, pleura, and osteoarticular sites, but can involve any organ.

Purpose of the Study:

  • To highlight the diagnostic challenges of extrapulmonary tuberculosis (TB).
  • To emphasize the importance of a high index of suspicion and thorough patient history, including human immunodeficiency virus (HIV) risk factors.
  • To review current therapeutic strategies and novel diagnostic approaches for extrapulmonary TB.

Main Methods:

Related Experiment Videos

  • Review of clinical presentation, diagnostic modalities, and treatment of extrapulmonary tuberculosis.
  • Discussion of diagnostic limitations, including negative smears, histopathology, and cultures.
  • Evaluation of novel diagnostic tools like adenosine deaminase levels and polymerase chain reaction (PCR).

    • Main Results:

    • Extrapulmonary TB diagnosis can be elusive, requiring empirical treatment initiation in some cases.
    • Standard antituberculous therapy regimens are generally effective for both pulmonary and extrapulmonary TB, with similar responses in HIV-infected and non-infected patients.
    • Extended treatment durations may be necessary for central nervous system and skeletal TB, and adjunctive corticosteroids can benefit specific severe forms.

    Conclusions:

    • Extrapulmonary tuberculosis presents diagnostic challenges, necessitating clinical vigilance and consideration of risk factors.
    • Prompt antituberculous therapy, potentially initiated empirically, is key to managing morbidity and mortality.
    • While standard regimens are effective, treatment duration and adjunctive therapies should be individualized based on site, drug resistance, and patient response.