Beyond the lungs: A case series of extrapulmonary tuberculosis

Globally, Tuberculosis (TB) is the leading infectious cause of death with more than 10 million cases and 1 million deaths from the disease annually. TB can present as a primary extrapulmonary infection without pulmonary symptoms or infection often mimicking other pathologies, thereby making its clinical manifestations uniquely difficult to diagnose in the Emergency Department.

We present five patients with rare cases of TB in an effort to underscore the importance of the EM physician keeping extrapulmonary infection in their differential.

Extrapulmonary TB is a high acuity, low incidence disease that must be on EM physicians' differential when considering susceptible patient populations with common ED chief complaints. Complications from undetected disease can result in significant patient morbidity and mortality.

Extrapulmonary TB is likely an underdiagnosed condition due to its often subtle and confounding presentations. The diagnosis should be considered in individuals with TB risk factors, HIV or other immunocompromised conditions, a history of TB infection and recurrent organ-specific infectious symptoms.