Extrapulmonary tuberculosıs: an old but resurgent problem

Abstract

Tuberculosis (TB) primarily affects the lungs, but some of its most devastating clinical consequences arise because of its ability to spread from the lungs to other organs. Extrapulmonary TB (EPTB) constitutes 15–20% of all TB cases. Imaging findings are not always specific and can mimic many diseases; therefore, EPTB should be considered in the differential diagnosis, particularly in patients with immune system disorders (AIDS, patients receiving chemotherapy, etc.) and those in other high-risk groups including people with diabetes. The bacterium's passage to the regional lymph nodes is essential for developing a protective T-cell-mediated immune response, but the bacterium can spread hematologically and via the lymphatic system, leading to extrapulmonary involvement. Diagnosis of EPTB in high-risk patients is made based on suspected clinical and radiological findings, but further positive culture and histopathological confirmation may be required in some instances. Radiological evaluations are critical for diagnosis and crucial in planning the treatment and follow-up. This paper aims to review the typical and atypical imaging features and the differential diagnosis of EPTB.

The diagnosis of leptospirosis complicated by pulmonary tuberculosis complemented by metagenomic next-generation sequencing: A case report

“…MTBC, on the other hand, predominantly infects humans via inhaling MTBC-containing aerosol droplets. Because of its respiratory-prone pathogenic characteristics, MTBC mainly affects lungs (i.e., PTB, roughly more than 80%), while in less frequent circumstances, it could also affects other organs (i.e., extrapulmonary tuberculosis, 15%–20%) ( Baykan et al., 2022 ). Here, in our case, MTBC was only detected in sputum in both Xpert MTB RIF and mNGS, whereas L. interrogans was detected in CSF, urine, and plasma, but not in sputum ( Table 2 ).…”

Murine infection by Mycobacterium marinum is a reliable model for Bone and Soft-Tissue Damage

“…The diagnostic challenge is further exacerbated due to inaccessibility of the tissues that often requires invasive procedures for sample collection and often the radiological features of the symptoms resemble with other diseases leading to inaccurate conclusion [36,37]. The prominent association of paradoxical reaction to EPTB than pulmonary TB poses more difficult challenge to decide most accurate therapeutic regimen [35,37,38]. Bone and joint TB/skeletal TB is one such EPTB which is characterized by the colonization of the bacterium to the bony tissues mostly spine but it can infect the whole skeleton like hip joint, knee joint etc.…”

“…The prominent association of paradoxical reaction to EPTB than pulmonary TB poses more difficult challenge to decide most accurate therapeutic regimen [35,37,38]. Bone and joint TB/skeletal TB is one such EPTB which is characterized by the colonization of the bacterium to the bony tissues mostly spine but it can infect the whole skeleton like hip joint, knee joint etc.…”

The utility of F‐18 FDG PET/CT for diagnosis and response evaluation of hepatosplenic tuberculosis

“…Among bacterial infections, tuberculosis is the most common infectious cause of FUO 1 . Extrapulmonary tuberculosis constitutes 15%–20% of all tuberculosis cases, 2 and radiological evaluations are critical for diagnosis and crucial in planning the treatment and follow‐up. F‐18 FDG is a highly influential radiotracer that provides valuable information for many cancer types, as well as inflammatory disease.…”