The evaluation of the cases with extrapulmonary tuberculosis

Abstract

Objective: Tuberculosis (TB) that can involve all organs is a disease progressing with a wide range of clinical presentations. It is especially difficult to diagnose the cases of extrapulmonary tuberculosis (EPTB) due to the atypical course, and the cases of EPTB constitute approximately 35% of all TB cases in our country. In our study, it was aimed to examine the distribution rates, diagnostic methods, and treatment processes of EPTB in terms of the involved systems. Material-Method: Of 308 patients diagnosed with TB, 119 cases having EPTB were retrospectively analyzed in The Konya Training and Research Hospital of Health Sciences University between 1st January 2015 and 30th June 2019. Results: While 119 (38.6%) EPTB cases of 308 cases diagnosed with TB were included in the study. 63 (52.9%) and 56 (47%) patients were women and men, respectively. The average age was found as 44.42±18.8 years (min: 18- max: 91 years). The distribution of involvement sites of EPTB was as follows: lymphadenitis, 45.3%; pleural tuberculosis, 24.3%; peritonitis, 14.2%; bone-joint tuberculosis, 7.5%; meningitis, 2.5%; miliary tuberculosis, 1.6%; others, 4.2%. In terms of EPTB, 83 (69.7%) cases were diagnosed histopathologically, 28 (23.5%) and nine (7.5%) were found to have culture and acido-resistant bacilli (ARB) positivity, respectively. A total of 29 (24.3%) cases were diagnosed microbiologically, and the purified protein derivative (PPD) positivity was detected in 106 (89%) cases. While the success rate of the treatment was found to be 93.2%, the mortality rate was measured as 3.3%. Conclusion: It should be kept in mind that TB is a common multisystem disease in our country and may present itself with a wide range of symptoms. In the presence of clinical suspicion, supportive tests should be performed; biopsy and culture samples should be obtained from the appropriate tissues; anti-TB treatment should be initiated at once if clinicians have sufficient evidence.

Keywords

• Extrapulmonary tuberculosis
• lymphadenitis
• pleural tuberculosis
• histopathological
• microbiological

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