Clinical misconceptions and diagnostic delays in extrapulmonary tuberculosis: an evaluation on 89 cases

Area of Science:

• Medical research
• Infectious diseases
• Tuberculosis

Background:

• Extrapulmonary tuberculosis (EPTB) exhibits diverse clinical presentations, complicating diagnosis compared to pulmonary tuberculosis (PTB).
• This study investigates the diagnostic challenges in 89 patients presenting with various complaints across different hospital clinics.

Purpose of the Study:

• To analyze the diagnostic difficulties associated with extrapulmonary tuberculosis.
• To identify factors influencing the time to diagnosis for different EPTB manifestations.

Main Methods:

• A cohort of 89 patients diagnosed with EPTB between March 2020 and March 2024 was retrospectively analyzed.
• Patients with primary pulmonary tuberculosis were excluded to define the EPTB cohort.

Main Results:

• The study included 89 patients (58.4% female), with a mean age of 47.84 years.
• Peripheral lymphadenopathy was more common in women (85.2%), while pleural involvement was more frequent in men (51.4%).
• Peripheral lymphadenopathy cases had a significantly longer time to diagnosis compared to pleural involvement (p < 0.001).
• Smoking was prevalent in males with pleural involvement (79.9%).

Conclusions:

• Extrapulmonary tuberculosis requires inclusion in the differential diagnosis across medical specialties due to its diagnostic complexity.
• Clinical suspicion should drive the pursuit of EPTB diagnosis, especially given the variable time to diagnosis based on affected site.