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[Extrapulmonary tuberculosis]
J Mazza-Stalder1, L Nicod, J-P Janssens
1Service de pneumologie, centre hospitalier universitaire Vaudois, Lausanne, Switzerland. Jesica.Mazza-Stalder@chuv.ch
Revue Des Maladies Respiratoires
|May 1, 2012
Summary
Extrapulmonary tuberculosis (TB) is rising, affecting women, Black individuals, and the immunocompromised. Diagnosis can be challenging due to varied symptoms and limited test sensitivity.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Context:
- Extrapulmonary tuberculosis (TB) cases are increasing, comprising 20-40% of all TB diagnoses.
- Higher prevalence observed in women, Black individuals, and immunosuppressed populations.
- Chest X-rays are often normal at diagnosis, complicating early detection.
Purpose:
- To review key clinical elements for diagnosing various forms of extrapulmonary TB.
- To assess the diagnostic yield of available tests for different TB presentations.
- To outline international therapeutic recommendations and practical management strategies.
Summary:
- Extrapulmonary TB presents diverse clinical manifestations, including lymphadenitis, pleuritis, and osteoarticular TB, with less frequent but challenging peritoneal, urogenital, and meningeal forms.
- Diagnostic difficulties arise from broad differential diagnoses and the low sensitivity of tests like cultures and genetic amplification.
- This review synthesizes clinical findings, diagnostic test performance, and current treatment guidelines for extrapulmonary TB.
Impact:
- Improved diagnostic strategies for challenging extrapulmonary TB cases.
- Enhanced clinical management through evidence-based therapeutic recommendations.
- Increased awareness of extrapulmonary TB's growing significance and specific risk factors.
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