Evaluation of Extrapulmonary Tuberculosis Patients in a State Hospital

Abstract

Aim: Tuberculosis is a disease that can affect any organ of the body, particularly the lungs, and remains a major public health problem worldwide. Extrapulmonary tuberculosis (EPTB) is a form of tuberculosis that occurs in organs and systems other than the lungs and is characterized by various clinical findings. The aim of this study was to evaluate the distribution, clinical findings and diagnostic methods of EPTB cases. Material and Methods: Data from patients diagnosed with EPTB between January 2017 and July 2023 were retrospectively evaluated. Demographic characteristics, comorbidities, organ and/or systemic involvement of tuberculosis, disease-related outcomes, and mortality rates were analyzed. Results: Of the 56 patients diagnosed with EPTB, 35 (62.5%) were female and 21 (37.5%) were male with a mean age of 46.4 ± 18.6 years. The most common comorbidity was diabetes mellitus. The most common form of EPTB was lymphadenitis (35.7%, n=20) and the second most common site of involvement was the pleura (n=8, 14.3%). The rarest form of EPTB was bone joint tulum (one patient, 1.8%). The distribution of affected lymph nodes was cervical (50%), axillary (35%), mediastinal (5%), and supraclavicular (5%). Microbiological findings (Asido resistance stain and/or tuberculosis culture and/or M. tuberculosis polymerase chain reaction) were positive in19 patients (33.9%), while histopathological findings (necrotizing granuloma with/without pathological caseation) supported the diagnosis in 33 patients. The overall mortality rate was 10.7%. Conclusion: EPTB is an important health problem that can cause mortality in developing countries. If clinically suspected, a diagnostic assessment based on microbiological, histopathological, radiological and clinical findings should be carried out and anti-tuberculosis treatment should be started immediately.

Keywords

• M. tuberculosis
• lymphadenitis
• Extrapulmonary tuberculosis

Bir Devlet Hastanesindeki Ekstrapulmoner Tüberküloz Hastalarının Değerlendirilmesi

Abstract

Amaç: Tüberküloz, başta akciğerler olmak üzere vücudun tüm organlarını etkileyebilen bir hastalıktır ve dünya genelinde önemli bir halk sağlığı sorunu olmaya devam etmektedir. Ekstrapulmoner tüberküloz (EPTB) ise, akciğer dışındaki organlarda ve sistemlerde görülen ve çeşitli klinik bulgularla seyreden bir tüberküloz formudur. Bu çalışmanın amacı, EPTB olgularının dağılımının, klinik bulgularının ve tanı yöntemlerinin değerlendirilmesidir. Gereç ve Yöntemler: Ocak 2017 ile Temmuz 2023 tarihleri arasında EPTB tanısı konan hastaların verileri retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, komorbiditeleri, tüberkülozun organ ve/veya sistem tutulumu ile hastalığa bağlı sekel ve mortalite oranları incelendi. Bulgular: Çalışmada EPTB konan 56 hastanın 35’i (%62,5) kadın, 21’i (%37,5) erkek olup yaş ortalaması 46,4±18,6 idi. En sık görülen komorbidite diyabetes mellitus idi. En sık görülen EPTB formu lenfadenit (%35,7, n=20) ve ikinci en yaygın tutulum bölgesi plevra (n= 8, %14,3) idi. En nadir görülen EPTB formu kemik eklem tulumuydu (bir hasta, %1,8). Tutulum gösteren lenf nodlarının dağılımına bakıldığında, servikal (%50), aksiller (%35), mediastinel (%5), ve supraklavikular (%5) şeklindeydi. Hastaların 19’unda (%33,9) mikrobiyolojik bulgular (Asidorezistan boyama ve/veya tüberküloz kültürü ve/veya M. tuberculosis polimeraz zincir reaksiyonu) pozitif bulunurken, histopatolojik bulgular (patolojik kazeifikasyonlu/patolojik kazeifikasyonsuz nekrotizan granülom) 33 (%58,9) hastada tanıyı destekleyici nitelikteydi. Genel mortalite oranı %10,7 idi. Sonuç: EPTB, gelişmekte olan ülkelerde mortaliteye sebep olabilen önemli bir sağlık sorunudur. Klinik şüphe durumunda mikrobiyolojik, histopatolojik, radyolojik ve klinik bulgular ile tanısal değerlendirme yapılmalı ve tüberküloz karşıtı tedaviye hemen başlanmalıdır.

Keywords

• M. tuberculosis
• lenfadenit
• ekstrapulmoner tüberküloz

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