[Extrapulmonary tuberculosis today]

In the past ten years 162 patients with extrapulmonary tuberculosis have been admitted to this hospital. They constituted 10% of the total number of patients with tuberculosis seen. The percentage of immigrants with extra-pulmonary disease was 39%, which was not only higher than the percentage of immigrants with pulmonary tuberculosis (25%) but also than their percentage in the total population (13%). The sites primarily affected were the pleura (28%), skeleton (23%) and urogenital tract (21%). Meningeal tuberculosis had the lowest incidence (1.9%). Altogether, 31% of the cases had additional pulmonary involvement which was active in half. Only one case proved to be an atypical mycobacteriosis. From our cases we conclude that modern invasive diagnostic methods are unevenly employed in Switzerland and surgical intervention is used too often, especially in the case of spondylitis. The favourable prognosis of purely conservative therapy is stressed. Based on recent reports in the literature, an attempt is made to establish guidelines for diagnosis and treatment.