Extrapulmonary tuberculosis

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Handbook of Tuberculosis

M. tuberculosis (MTB) can cause disease in almost any organ of the body. Extrapulmonary tuberculosis (EPTB) is defined as tuberculosis (TB) disease outside of the lung parenchyma [1]. Much like pulmonary TB, EPTB can occur as a primary infection or as reactivation of a latent focus with subsequent spread. In primary infection the bacilli enter the body through the lungs and then disseminate to other parts of the body either via the lymphatic system or hematogenously; alternatively a latent foci of bacilli may reactivate and then disseminate in the same way. Globally, EPTB accounts for approximately 15 % of new TB cases, but may be underreported due to diagnostic challenges; many cases of EPTB continue to be diagnosed and treated based on clinical presentation and without microbiological confirmation [1]. Extrapulmonary or disseminated disease can be seen in more than 50% of patients with concurrent HIV and TB as a consequence of immune suppression. Overall, the myriad presentations of EPTB create a significant challenge for clinicians. Symptoms are often specific to the organ system involved and may mimic more common disease conditions. Diagnosis of extrapulmonary forms of TB often require site-specific microbiological evaluations for MTB, which can be difficult.

Treatment for EPTB is similar to treatment of pulmonary TB, but duration and need for concomitant steroids or other interventions may differ depending on the site of disease.


Shah M, Chida N. Extrapulmonary tuberculosis. In: Grosset JH, Chaisson RE, eds. Handbook of Tuberculosis. Cham, Switzerland: Springer International Publishing Switzerland. 2017:91-118. DOI: 10.1007/978-3-319-26273-4