Incidence, risk factors and clinical characteristics of extra‐pulmonary tuberculosis patients: a ten‐year study in the North of Iran

Shirzad‐Aski, Hesamaddin; Hamidi, Niloofar; Sohrabi, Ahmad; Abbasi, Abdollah; Golsha, Roghieh; Movahedi, Jamileh

doi:10.1111/tmi.13452

Cited by 13 publications

(9 citation statements)

References 34 publications

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“…[ 10 ] Although the clinical symptoms were observed according to the site involved, like others, we also observed fever (97.3%) as the most common symptom, followed by loss of appetite (78.9%) and weight loss (69.1%). [ 11 , 12 ] In the present study, the maximum samples were pleural fluid (30%), followed by CSF (24.7%), ascitic fluid (16.5%), lymph node aspirate/tissue (14.7%), and pus (9.6%). Similarly, various other studies have reported pleural fluid as the most common sample received.…”

Section: Discussionmentioning

confidence: 43%

Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard

Chaudhary,

Chawla,

Gupta

et al. 2023

International Journal of Applied &Amp; Basic Medical Research

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Introduction: Xpert Ultra (Cepheid, USA) is recently introduced with an extra category of trace-positive results and higher sensitivity for tuberculosis (TB) diagnosis. Objective: The objective of the study was to assess the diagnostic accuracy of Xpert Ultra for extrapulmonary samples using culture and composite reference standard (CRS) as the gold standard. Materials and Methods: In a 1-year (March 2021–22) prospective observational study, samples of suspected extrapulmonary TB (EPTB) patients were subjected to Ziehl–Neelsen staining, culture, and Xpert Ultra (Cepheid, Sunnyvale, CA) tests. Relevant clinical and treatment information was noted. The diagnostic accuracy of Xpert Ultra compared with culture and CRS was calculated. Results: Out of 1720 suspected patients of EPTB, 223 (13%), predominantly males 135 (60%), with a mean age of 41.46 ± 19.81 years, were diagnosed as TB positive following CRS criteria. The maximum cases were of pleural TB (35.4%), followed by central nervous system TB (17.9%), gastrointestinal TB (17.5%), and lymph node TB (12.1%). Of all samples, 150 (8.7%) were microbiologically confirmed, including 141 detected by Xpert ultra, 67 culture positive, and only 16 smear positive. Among the Xpert Ultra-positive samples, 35 showed trace results, including six false-positive results. Considering culture and CRS as the gold standard, the sensitivity (86.57%, 59.64%) and specificity (94.98%, 99.47%) of Xpert Ultra were calculated, respectively. Rifampicin resistance was detected in 1 (0.70%) sample. Conclusion: Diagnosis of EPTB is a challenge and Xpert Ultra may detect TB at a very early stage. However, it is essential to rule out false-positive results. Additional studies are needed on Xpert Ultra to interpret trace results better.

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Section: Discussionmentioning

confidence: 43%

Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard

Chaudhary,

Chawla,

Gupta

et al. 2023

International Journal of Applied &Amp; Basic Medical Research

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“…Since, the organ-specific symptoms are predominant and variable in each case, the constitutive symptoms are less common in EPTB. In a study from Iran, fever, fatigue, and night sweats were the most common complaints of the patients [33]. Bal et al, found that common symptoms in our country were fever, night sweats, and weight loss [30].…”

Section: Discussionmentioning

confidence: 79%

Demographic and microbiological characteristics of tuberculous lymphadenitis and other extrapulmonary tuberculosis cases

ALTUNAL

Şengel

OZEL

et al. 2022

Marmara Medical Journal

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Objective: Tuberculosis (TB) is a significant public health problem that remains important worldwide. This study aimed to examine the demographic characteristics and clinical features of patients with extrapulmonary tuberculosis (EPTB) and also identify the comorbidities of EPTB. Our secondary aim was to compare tuberculous lymphadenitis (TBL) with other forms of EPTB. Patients and Methods: This single-center, retrospective, observational study was conducted on patients diagnosed with EPTB in a training hospital in Turkey between January 1, 2011 and December 31, 2020. The demographic characteristics and clinical features of the patients were examined. TBL cases were compared with other forms of EPTB cases. Results: The most common clinical form was TBL. Fever, night sweats, and accelerated erythrocyte sedimentation rate were significantly more common in the other forms of the EPTB group compared to TBL. The rate of tuberculin skin test positivity was significantly higher in patients with TBL. The complication rate was 3%, and mortality rate was 4% among all patients. Conclusions: Extrapulmonary tuberculosis should be considered in the differential diagnosis by evaluating the medical history of patients who present with organ-specific symptoms, especially in TB endemic countries. The clinic may differ according to the organ involvement. TBL may be seen with milder symptoms compared to other clinical forms.

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“…Osteoarticular tuberculosis is the second most common forms of extrapulmonary tuberculosis which is only less than spinal TB. 1,2,12 Hip tuberculosis (TB) is the most common osteoarticular tuberculosis, 13 consisting of 10% to 15% of total joint TB cases. Early-stage tuberculosis of the hip is often undetected due to its atypical symptoms.…”

Section: Discussionmentioning

confidence: 99%

Early clinical outcomes of one-stage total hip arthroplasty for the treatment of advanced hip tuberculosis

Chen

Yin

et al. 2021

J Orthop Surg (Hong Kong)

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Objective: To investigate the clinical efficacy of one-stage total hip arthroplasty (THA) for treating the advanced hip tuberculosis. Methods: A retrospective study was conducted from July 2013 to June 2018, including 19 patients with advanced hip tuberculosis. All patients underwent total hip arthroplasty through posterior approach, and the surgical efficacy was evaluated. Results: Nineteen patients were followed up from 24 months to 48 months, the mean follow-up were 32.1 months. All the incisions healed in grade A. There were no aseptic loosening, dislocation or recurrence of hip tuberculosis after operation. At the last follow-up, the Harris score of the patients was (89.3 ± 6.7), which was significantly higher than (38.2 ± 10.5) of the patients before operation (P < 0.05); the flexion-extension range of motion was (93.6° ± 12.1°), which was significantly larger than (38.2° ± 10.5°) of the patients before operation (P < 0.05). Conclusion: The one-stage total hip arthroplasty with regular antituberculosis treatment can attain satisfactory clinical efficacy in the treatment of advanced hip tuberculosis, which can relieve the joint pain and improve the joint function, without recurrence of hip tuberculosis.

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Incidence, risk factors and clinical characteristics of extra‐pulmonary tuberculosis patients: a ten‐year study in the North of Iran

Cited by 13 publications

References 34 publications

Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard

Diagnostic Efficacy of New Xpert Ultra for Extrapulmonary Tuberculosis Using Culture and Composite Reference Standard

Demographic and microbiological characteristics of tuberculous lymphadenitis and other extrapulmonary tuberculosis cases

Early clinical outcomes of one-stage total hip arthroplasty for the treatment of advanced hip tuberculosis

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