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Extrapulmonary tuberculosis--a continuing problem in Australia.

D E Dwyer¹, C MacLeod, P J Collignon

¹Registrar, Department of Medicine, Westmead Hosptial, NSW.

Australian and New Zealand Journal of Medicine

|October 1, 1987

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Extrapulmonary tuberculosis (TB) is a significant health issue in Australia. This study highlights key epidemiological and clinical features for earlier recognition and treatment of this disease.

Area of Science:

Medical Microbiology
Infectious Diseases
Public Health

Background:

Extrapulmonary tuberculosis (TB) constitutes a significant portion of new TB notifications in Australia.
Early recognition and treatment are crucial for managing extrapulmonary TB.

Purpose of the Study:

To assess the epidemiology and clinical features of extrapulmonary TB.
To identify factors for earlier diagnosis and risk stratification.

Main Methods:

Retrospective review of 51 extrapulmonary TB cases at Westmead Hospital (1980-1985).
Analysis of patient demographics, disease sites, clinical presentation, and diagnostic confirmation.
Correlation of disease patterns with geographic origin.

Main Results:

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Most patients (38/51) were born outside Australia, primarily from South-East Asia and Europe.
Common sites included lymph nodes (predominantly in South-East Asians), genitourinary tract (in Caucasians), pleura, and bone.
Laboratory confirmation was high (88%), with Mycobacterium tuberculosis isolation in 69% of submitted specimens.
Drug resistance was observed only in isolates from South-East Asian patients.

Conclusions:

Extrapulmonary TB epidemiology in Australia is linked to immigration patterns, with distinct site predilections based on origin.
Clinical presentation can be subtle, emphasizing the need for high diagnostic suspicion.
Laboratory confirmation and drug resistance patterns are critical for effective management.