Evaluation of Pulmonary and Extrapulmonary Tuberculosis in Immunocompetent Adults: A Retrospective Case Series Analysis

Abstract

Objective: It was the aim of this study to evaluate the demographic factors and clinical features of extrapulmonary tuberculosis (EPTB) compared to those of pulmonary tuberculosis (PTB) among adult immunocompetent patients. Subjects and Methods: A total of 427 patients with clinically, radiologically and histopathologically confirmed TB were enrolled in the study, in our clinic at a tertiary care hospital in Turkey, during a 5-year period (2007-2012). Patient data were obtained retrospectively. Among the 427 patients, 55 patients with both PTB and EPTB and who were using steroids or had taken immunosuppressive drugs were excluded from the study. Results: Of the 372 patients, 227 (61%) were males and 168 (45.2%) had EPTB; 204 (54.8%) patients had PTB. The most frequent sites of EPTB were the lymph nodes (n = 45, 12.1%), pleura (n = 40, 10.7%) and brain (n = 7, 1.8%). The most common symptoms were cough (n = 174, 46.7%), night sweats (n = 127, 34.1%) and fever (n = 123, 33%). Compared to EPTB patients, PTB patients were less likely to have received Bacillus Calmette-Guérin vaccination (odds ratio 0.41, 95% confidence interval 0.2-0.63; p < 0.001). Eighty-one (48.2%) of the EPTB and 146 (71.6%) of the PTB patients were males. Pulmonary involvement was more common among men (n = 146, 71.6%) than among women (n = 58, 28.2%; p = 0.000). Conclusion: There was a high incidence of EPTB in our study. Early diagnosis of EPTB is crucial for treatment, and atypical presentations of TB should be kept in mind for immunocompetent patients living in endemic areas. Females especially should be investigated for EPTB.

Identification of Mycobacterium tuberculosis in Clinical Specimens of Patients Suspected of Having Extrapulmonary Tuberculosis by Application of Nested PCR on Five Different Genes

“…Tuberculosis (TB) is a serious disease which accounts a major global public health problem worldwide (Ates Guler et al, 2014). According to the (World Health Organization, 2014), Mycobacterium tuberculosis complex (MTBC) has infected nearly one-third of the world's population, and TB remains as one of the top ten leading cause of death in the world.…”

Comparative analysis of pulmonary and extrapulmonary tuberculosis of 411 cases

“…Tuberculosis (TB) is a chronic, granulomatous, bacterial infection that may display multisystemic involvement. It still constitutes a major global health problem and it is estimated that almost one-third of the population is infected worldwide [ 1 , 2 ]. Main microbiological agent is Mycobacterium tuberculosis in the vast majority of cases [ 2 ].…”

“…Main microbiological agent is Mycobacterium tuberculosis in the vast majority of cases [ 2 ]. The disease may transform into the active phase in 10 % of cases and lungs are the most common site of involvement [ 1 – 3 ].…”

“…The proportion of PTB to EPTB varies with respect to geographical, social, ethnic and economical parameters [ 3 ]. The rate of extrapulmonary tuberculosis (EPTB) patients in Turkey is estimated as 39 %-45.1 % [ 1 ].…”

“…The most common sites for EPTB are lymph nodes, pleura, cutaneous tissue, abdomen, gastrointestinal system and bones [ 1 , 3 , 4 ]. Attributed to its atypical presentation, diagnostic difficulties, increasing prevalence and potential to result in hazardous sequelae, increased clinical awareness for EPTB is crucial [ 2 , 5 ].…”