During 200211, 167,652 cases of extrapulmonary tb were reported by the. Mar 24, 20 one in five tb patients in eueea has extrapulmonary tuberculosis. Extrapulmonary tuberculosis eptb constitutes about 20% of all cases of tuberculosis tb in korea. Nov 15, 2009 trends in extrapulmonary tuberculosis eptb and pulmonary tuberculosis ptb, united states 19932006. Up to 25% of tuberculosis cases present extrapulmonary involvement. Please tell us where you read or heard it including the quote, if possible. Diagnosis and treatment of extrapulmonary tuberculosis ji yeon lee, m. Extrapulmonary sites of infection commonly include lymph nodes, pleura, and osteoarticular areas, although any organ can be involved.
Extrapulmonary tuberculosis germaine jacquette, md clinical assistant professor njms global tuberculosis institute may 4, 2012 tb cases by site of disease united states, 2000 2010 year total cases pulmonary extrapulmonary 2000 16, 309, 086 80% 3, 211 20% 2001 15, 945 12, 724 3, 217 2002 15, 055 11,901 3, 148 2003 14 83514, 835 11. This occurs in 1520% of active cases, causing other kinds of tb. Tuberculosis is the most common fatal infectious disease in the world. Medical records of 411 patients 190 women, 221 men. Extrapulmonary tuberculosis free download as powerpoint presentation. The high frequency is related to the failure of the immune response to contain m. As a result of that spread and thanks to the development. Extrapulmonary tb occurs more commonly in immunosuppressed persons and young children. Most common sites include lymph nodes 19%, pleura 7%, gastrointestinal tract 4%, bone 6%, cns 3% and.
Department of internal medicine, national medical center, seoul, korea extrapulmonary tuberculosis eptb constitutes about 20% of all cases of tuberculosis tb in korea. In contemporary practice, clinicians neither start nor stop treatment for this condition based solely on pcr results. Tuberculosis tb is one of the main health issues in turkey. Extrapulmonary tb disease may cause symptoms related to the part of the body that is affected table 4. Derive from scratch by this method, body diagrams can be derived by pasting organs into one of the plain body images shown below. Extrapulmonary tuberculosis has become more common. Epidemiology of extrapulmonary tuberculosis in brazil. Extrapulmonary tuberculosis eptb is defined as tuberculosis tb disease outside of the lung parenchyma 1. Epidemiological risk factors include birth in high tbprevalent countries, exposure at place of residencework in an institutional setting, and homelessness.
The most likely reasons are an increased recognition of extrapulmonary tuberculosis and an increasing. If you continue browsing the site, you agree to the use of cookies on this website. Extrapulmonary tb eptb results from the hematogenous and lymphatic spread of rculosis bacilli. Diagnosis may be delayed as a result of nonspecific clinical manifestations that progress slowly and the low sensitivity of acidfast bacilli afb smear on extrapulmonary specimens. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberculosis refers to an infectious disease associated with the lungs, which is mostly caused by bacteria. It is usually caused by reactivation of latent infection and may cause disease at almost any site in the body. Extrapulmonary tuberculosis tb refers to the haematogenous spread of mycobacterium tuberculosis pathology. The most common site for infection with mycobacterium tuberculosis worldwide is the lungs, but dissemination can occur to any part of the body, resulting in extrapulmonary tuberculosis eptb.
This ecdc video documentary featuring two patient stories illustrates how difficult the diagnosis of extrapulmonary tb can be. Although extrapulmonary tuberculosis eptb is less frequent than pulmonary tuberculosis ptb and is a secondary target for national tb control programs, its significance has increased worldwide during the hiv epidemic. The basic principles of treatment for extrapulmonary tuberculosis eptb are the same as pulmonary tb with a few exceptions. List of tuberculosis, extrapulmonary medications 3 compared. Extrapulmonary tuberculosis is tuberculosis tb within a location in the body other than the lungs. The diagnosis of extrapulmonary tuberculosis can be elusive, necessitating a high index of suspicion. Improving the diagnosis and treatment of smearnegative. Extrapulmonary tuberculosis and hiv infection extrapulmonary involvement can be seen in more than 50 percent of patients with concurrent aids and tuberculosis. Diagnosis of extrapulmonary tuberculosis by smear, culture. Extra pulmonary tuberculosis symptoms, signs, causes, risk. Rates of smearnegative pulmonary and extrapulmonary tuberculosis have been rising in countries with hiv epidemics.
Extrapulmonary tuberculosis is defined according to who classification criteria as an infection by m. The goals of treatment of tb are to cure the patient clinically and minimize the chance of relapse, and to prevent further transmission of tb to others. Epidemiology of extrapulmonary tuberculosis in the united. A retrospective analysis was carried out on 474 tuberculosis tb. Who are the patients with extrapulmonary tuberculosis. Clinical manifestations of pulmonary and extrapulmonary.
Disease patterns since have changed, with a higher incidence of disseminated and extrapulmonary disease now found. This patient was diagnosed as having smear positive pulmonary tuberculosis and received supervised. Extrapulmonary medical definition merriamwebster medical. Often arthritis due to tb is a chronic monoarthritis, starting insidiously, with little or no pain and accompanied by joint. In the uk, the proportion of eptb has increased relative to that of pulmonary tuberculosis tb. However, similar studies from highburden countries like nepal are lacking. The most common locations are the lymph nodes, pleura and the osteoarticular. Extrapulmonary tuberculosis approach bmj best practice. Burke from the royal edward laurentian hospital, montreal, quebec, canada certain recent studies have shown that some extrapulmonary lesions of tuberculous etiology, long held to be bloodborne in origin, are really the result of lymphogenous dissemination of tubercle bacilli. Abdominal tuberculosis, which is a form of extrapulmonary tuberculosis, affects the gastrointestinal tract, spleen, pancreas, liver, peritoneum, omentum and lymph nodes adjacent to these organs. This article describes three cases of extrapulmonary tuberculosis eptb of the spine that presented to australian general practices. Extrapulmonary tubercuosis can occur as a primary form of the disease, i.
A new approach to the pathogenesis of extrapulmonary tuberculosis. Extrapulmonary tuberculosis symptoms, diagnosis and. This is produced by hematogenous and lymphatic spread of the m. Extrapulmonary tuberculosis radiology reference article. Usa, the incidence of extrapulmonary tuberculosis ranged from 15 to 37 percent of all new cases of active tuberculosisl,2,4. The recent human immunodeficiency virus hiv and acquired immunodeficiency syndrome aids pandemic has resulted in changing epidemiology and has once again brought. Extrapulmonary tuberculosis in hivinfected patients. Comparative analysis of pulmonary and extrapulmonary. The objective of this study was to examine the epidemiology of eptb in brazil between 2007 and 2011. Epidemiological risk factors include birth in high tb prevalent countries, exposure at place of residencework in an institutional setting, and homelessness. There are various types under each type of tuberculosis. This infographic explains what tuberculosis and extrapulmonary tuberculosis is. Tuberculosis can become active in other parts of the body, whether or not the lungs are involved.
Extrapulmonary tuberculosis an overview sciencedirect. Serafino wani mbbs, mrcp, msc trop meda diabetes mellitus, neoplastic diseases. Assessment of extrapulmonary tuberculosis in two provinces of. Pdf diagnosis and treatment of extrapulmonary tuberculosis. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristics between eptb and ptb patients. Diagnosing eptb remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Jun 24, 2015 tuberculosis is a disease that can involve every organ system. Jan 24, 2008 studies from developed countries have reported on hostrelated risk factors for extra pulmonary tuberculosis eptb. There are two types of tuberculosis, that are pulmonary tuberculosis and extrapulmonary tuberculosis. While pulmonary tuberculosis is the most common presentation, extrapulmonary tuberculosis ept is also an important clinical problem. There are several hypotheses to explain the continuing prevalence of extrapulmonary tuberculosis. Crosssectional study involving all cases of tb reported to the brazilian. Therapy for eptb requires a minimum of 6 months of treatment.
Extrapulmonary tuberculosis still constitutes approximately 20% of new cases in the us and a greater proportion of cases overseas. Eptb refers to tb involving organs other than the lungs e. Extrapulmonary tb may represent a sequel of primary infection or reactivation disease. Tuberculosis of bones and joints is mostly found in children, probably because of better vascularisation and oxygenation of osteoarticular structures during growth. This method requires a graphics editor that can handle transparent images, in order to avoid white squares around the organs when pasting onto the body image. The current study aimed to outline and compare the demographic and clinical features of pulmonary and extrapulmonary tuberculosis cases in adults. Nov 01, 2005 extrapulmonary involvement can be seen in more than 50 percent of patients with concurrent aids and tuberculosis. Diagnosis of extrapulmonary and introduction paediatric. Tuberculosis may be classified according to site of disease as pulmonary or extrapulmonary. Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis tb. Clinical manifestations of pulmonary and extrapulmonary tuberculosis robert l. The denominator is the total number of eptb and ptb cases per year, excluding disseminated cases and concurrent extrapulmonarypulmonary tuberculosis cases. Much like pulmonary tb, eptb can occur as a primary infection or as reactivation of a latent focus with subsequent spread. Extrapulmonary tuberculosis is challenging to diagnose, but knowledge of its pathophysiology and imaging features can help the radiologist identify this infectious disease in highrisk patients.
For active tb disease, a small subset of patients 19. The clinical features of these diseases and complications may modify those of tuberculosis and so hinder diagnosis 10. Extrapulmonary tb eptb results from the hematogenous and lymphatic spread of m. Apr 02, 2015 the two types of clinical manifestation of tuberculosis tb are pulmonary tb ptb and extrapulmonary tb eptb. Disseminated tuberculosis occurs because of the inadequacy of host defenses in. Jan 09, 2015 extrapulmonary tuberculosis varied presentation difference in management slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. These are collectively denoted as extrapulmonary tuberculosis. Extrapulmonary tb cases have significant proportion comparing pulmonary tb cases. Abstract up to 25% of tuberculosis cases present extrapulmonary involvement. This patient was diagnosed as having smear positive pulmonary tuberculosis and. The present report concerns a case of pulmonary nocardiosis in an immunocompetent host.
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