Reactivation and Dissemination of Tuberculosis to Extrapulmonary Sites in Patients With Hematologic Malignancies

Abstract

The increased utilization of immunosuppressive, antineoplastic agents in patients with hematologic malignancies and hematopoietic stem cell transplant recipients impairs humoral and cellular immunity. As a result, susceptibility to infectious diseases, including reactivation/development of tuberculosis and its dissemination to extrapulmonary sites, is a serious concern. Tuberculosis dissemination to extrapulmonary sites can mimic both clinical and radiological presentations of other etiologic agents. Thus, early diagnosis is often challenging. We present 3 cases of tuberculosis infection, of which 2 disseminated to extrapulmonary sites in patients with hematologic malignancies, along with literature review, clinical presentation, diagnostic evaluation, and differential diagnosis.