Prevalence and Its Predictors of Extrapulmonary Involvement in Patients with Pulmonary Tuberculosis

Abstract

Extrapulmonary organ involvement in human immunodefiaency virus (HIV)-infected patients with pulmonary tuberculosis (TB) is reported to be 26%, however, the clinical predictors of extrapulmonary involvement in pulmonary TB patients has not been reported yet. We tried to determine the clinical predictors of presence of extrapulmonary involvement in patients with pulmonary TB. Cross-sectional study was performed including all adult patients with culture-proven pulmonary TB diagnosed between January 1, 2004 and July 30, 2006, at a tertiary referral hospital in South Korea. The presence of extra-pulmonary TB involvement was diagnosed based on bacteriological, pathological, or clinical evidence. Among 320 patients with a culture-proven pulmonary TB, 40 had extrapulmonary involvement. Patients with bilateral lung involvement were more likely to have extrapulmonary involvement, with an adjusted odds ratio (OR) of 4.21 (95% confidence interval [CI], 1.82-9.72), while patients older than 60 yr (adjusted OR, 0.27; 95% CI, 0.08-0.89), patients with cavitary lesions (adjusted OR, 0.37; 95% CI, 0.16-0.84), and with higher levels of serum albumin (adjusted OR, 0.45; 95% CI, 0.25-0.78) had less frequent involvement. Clinicians should be aware of the possibility of extrapulmonary involvement in TB patients with bilateral lung involvement without cavity formation or lower levels of serum albumin.

Role of risk factors and socio‐economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India

“…(2009) (5.8%). CLD has not been studied much as a risk factor; the 3.9% prevalence we observed among patients with PTB was similar to that in a study from Korea (Kim et al. 2009).…”

“…2009), chronic kidney disease (CKD) (Al‐Shoaib 2000; Venkata et al. 2007) and chronic liver disease (CLD) (Kim et al. 2009).…”

Osteoarticular Manifestations of Mycobacterium Tuberculosis Infection

“…In addition, patients with bilateral lung TB have a greater risk for developing EPTB. Interestingly, a decreased risk for EPTB is noted in patients with higher serum albumin levels, who were older than 60 years or with cavitary lesions (Kim et al, 2009). In the musculoskeletal system, any bone, joint, tendon, or bursa has the potential for TB infection.…”

“…Some common extrapulmonary sites for infection include the brain, meninges, musculoskeletal system, gastrointestinal organs, genitourinary organs, pericardium, and pleura (Kim et al, 2009;Mihalko & Martinez, 2007). Extrapulmonary TB is frequently coupled with a preexisting compromised immune system in the infected person.…”

Sociocultural and host factors related to extra-pulmonary tuberculosis in rural Bangladesh: A case control study

“…Lymph node tuberculosis comprised the highest number of EPTB in almost all studies. [8][9][10][11][12] The central nervous system was found next most frequent site of EPTB involvement, followed in descending order by skeletal, pleural, abdominal, cutaneous, genitourinary, pericardial, disseminated (military), and breast tuberculosis. 10 Literatures revealed, age, income, occupation, race, sex, malnutrition, vitamin D deficiency, biomass fuel exposure, HIV positivity, diabetes, renal disease, drinking unpasteurized milk, as important factors for extra-pulmonary tuberculosis.…”