Documento de consenso sobre diagnóstico, tratamiento y prevención de la tuberculosis

Tuberculosis extrapulmonar, una revisión

“…As for BCG vaccinated individuals, the effect of the vaccine can interfere with TB infection, and so it has been established that for high-risk vaccinated populations indurations of 5mm or more are considered positive 6 . Techniques based on the detection of interferon gamma (interferon gamma release assays or IGRA) have additional advantages over PPD tests.…”

“…In extrapulmonary TB the inherent difficulty to obtain microbiological samples makes radiology and other imaging techniques such as CT or MRI very helpful in the diagnostic approach and in taking samples through biopsy. Isotopic techniques such as positron emission tomography (PET-CT) may early detect inflammatory activity but they are highly unspecific for the diagnosis 6 . Definite diagnosis however requires the detection of M. tuberculosis.…”

“…Its main disadvantage is that its results take between 2 and 6 weeks to be ready in solid culture media. As to minimize this period, liquid culture mediums have been developed and they enable the detection of bacterial growth between 7 and 10 days before solid media 6 . Molecular methods based on the amplification of M. tuberculosis specific genetic fragments allow a rapid diagnosis over direct samples and they may detect gene mutations responsible for antimicrobial resistance.…”

Tuberculosis como causa de adenopatías cervicales

“…Las adenopatías tienden a crecer gradualmente y en principio son de consistencia rígida e indolora. Con el tiempo pueden sufrir necrosis, fluctuar y presentar signos inflamatorios con fistulización y drenaje de caseum al exterior, lo que se conoce como escrófula 3 .…”

“…Entre los órganos extrapulmonares más afectados por la tuberculosis en pacientes VIH están los ganglios linfáticos, tanto periféricos como intratorácicos o intraabdominales. La presencia de adenopatías significativas en cualquier territorio junto con fiebre u otras manifestaciones en pacientes positivos al VIH debe sugerir como primera posibilidad diagnóstica la TBC 3 .…”