Tb

Extrapulmonary Tuberculosis

search

Extrapulmonary Tuberculosis, Disseminated tuberculosis, Miliary Tuberculosis

  • See Also
  1. Tuberculosis
  2. Tuberculosis Screening in Children
  3. Tuberculosis Risk Factors (Tuberculosis Screening Indications)
  4. Tuberculosis Risk Factors for progression from Latent to Active Disease (Latent Tuberculosis Treatment Indications)
  5. Tuberculosis Related Chest XRay Changes
  6. Tuberculin Skin Test (TST, Purified Protein Derivative, PPD)
  7. Mycobacterium Tuberculosis Antigen-Specific Interferon-Gamma Release Assay (IGRA)
  8. Latent Tuberculosis Treatment
  9. Active Tuberculosis Treatment
  10. Susceptible Tuberculosis Treatment
  11. Possibly Resistant Tuberculosis Treatment
  12. Multiple Drug Resistant Tuberculosis Treatment
  13. Tuberculosis Resources
  • Distribution
  • Areas of Dissemination
  1. Tuberculous Lymphadenitis or Scrofula (most common non-pulmonary form)
    1. Cervical Lymphadenopathy is most common
    2. Swollen and matted nodes that may drain
  2. Pleural Tuberculosis (5%) and Pleural Effusions
  3. Skeletal Tuberculosis (35%)
    1. Thoracic and Lumbar Spine involvement of intervertebral discs and Vertebrae (Pott's Disease)
    2. Chronic Monoarthritis may also occur
  4. Tuberculous Meningitis (with CNS Granulomas)
    1. CSF with moderate Lymphocytosis
  5. Gastrointestinal Tuberculosis
  6. Genitourinary Tuberculosis
  7. Tuberculous Peritonitis
  8. Tuberculous Pericarditis and Pericardial Effusion
  9. Miliary Tuberculosis (Disseminated tuberculosis)
    1. Named for its tiny Millet Seed sized Granulomas widely distributed (similar to shotgun pellets)
    2. Seen in AIDS and untreated Tuberculosis
    3. Presents with fever, Night Sweats, weight loss
    4. PPD is positive in only 50% of cases
  • Management
  1. See Active Tuberculosis
  2. Duration of therapy (phase 1 and 2 combined)
    1. Most forms of Extrapulmonary Tuberculosis: 4-7 months
    2. CNS Tuberculosis: 9-12 months
    3. Musculoskeletal Tuberculosis: Extended duration
  3. Phase 1: First 2 months (altered if suspect resistance)
    1. Isoniazid
    2. Rifampin
    3. Pyrazinamide
    4. Ethambutol
  4. Phase 2: Duration varies per guidelines above
    1. Isoniazid
    2. Rifampin
  • References
  1. Golden (2005) Am Fam Physician 72(9):1761-8 [PubMed]