The silent pandemic in South Africa: Extra-pulmonary tuberculosis from head to heel

Roux, Camilla E Le; Vlok, Sucari S.C.

doi:10.4102/sajr.v25i1.2026

Cited by 3 publications

(4 citation statements)

References 11 publications

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“…When left untreated, it carries a mortality rate ranging from 6% to 20%. Surgery is not mandatory unless complications arise that do not respond to medical therapy [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…Dissemination may also occur through surgical or diagnostic manipulation of a previously infected organ. A normal chest radiograph or negative laboratory tests do not exclude extrapulmonary TB, a diagnosis that necessitates a high index of diagnostic suspicion [3]. Most cases of extrapulmonary TB occur in organs that do not offer optimal conditions for bacillary growth, leading to an insidious onset of the disease [4].…”

Section: Introductionmentioning

confidence: 99%

“…The most common extrapulmonary forms of TB include pleural, lymphatic, osteoarticular, genitourinary, and intestinal, although virtually any organ within the body can be affected. Tuberculous pleurisy stands as the most prevalent extrapulmonary form of TB in immunocompetent adults [3].…”

Section: Introductionmentioning

confidence: 99%

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Same Pathogen, Different Manifestations: A Case of Extrapulmonary Tuberculosis

Cabrera,

Mota

2023

Cureus

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Tuberculosis (TB) remains the most prevalent contagious disease worldwide and a significant cause of morbidity, ranking as the second most deadly disease globally. The transmission of the disease occurs through aerosols via the respiratory route, predominantly affecting pulmonary tissue. However, the pathogen can disseminate and infect any organ within the body. Up to 15% of patients exhibit extrapulmonary involvement.The case involves a 59-year-old male who presented to the emergency department complaining of abdominal pain and subfebrile episodes, without any other significant symptoms or findings on physical examination. Laboratory investigations revealed elevated inflammatory markers and abnormal liver biochemistry parameters. A computed tomography (CT) scan showed a neoformative lesion in the liver -a collection with a vascularized, thick, irregular wall. This raised the possibility of a potentially hypervascular hepatic neoformation or an encysted inflammatory lesion. The patient was started on empirical broadspectrum antibiotics and was admitted to the Internal Medicine ward for further investigation. Later, the patient began to exhibit a decline in overall condition, a slowed and less complex speech pattern, loss of balance, and distal tremors in the upper limbs, as well as a symmetric and distal reduction in strength in all four limbs. A cerebral CT scan revealed no significant abnormalities, and a lumbar puncture yielded no immediate notable findings. Simultaneously, a repeated abdominal CT scan showed the previously known hepatic lesion, albeit with features more indicative of a multiloculated collection. An aspirative biopsy of the hepatic abscess was conducted. From the extensive analysis conducted, a positive PCR result for mycobacterium tuberculosis was identified in both the pus from the hepatic abscess and the cerebrospinal fluid. This led to the conclusion that the case presented was an instance of extrapulmonary TB involving the liver and the central nervous system. Following the identification of the causative agent, the patient commenced antibacterial therapy comprising rifampicin, ethambutol, and isoniazid with adjunctive dexamethasone. Despite targeted treatment and instituted supportive therapy, the patient exhibited an unfavorable progression and eventually succumbed 57 days after diagnosis. This case highlights an unusual manifestation of a patient with disseminated extrapulmonary TB, emphasizing the importance of early diagnostic suspicion for clinicians. The unfavorable disease progression despite appropriate targeted treatment prompts reflection on whether the delay in diagnosis and provision of anti-TB drugs may have played a major role in the prognosis of the patient.

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“…When left untreated, it carries a mortality rate ranging from 6% to 20%. Surgery is not mandatory unless complications arise that do not respond to medical therapy [3,4].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Same Pathogen, Different Manifestations: A Case of Extrapulmonary Tuberculosis

Cabrera,

Mota

2023

Cureus

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“…EPTB refers to TB involving organs other than the lungs (e.g., pleura, lymph nodes, abdomen, genitourinary tract, skin, joints and bones, meninges or genitourinary system). EPTB is more common in patients who are infected with HIV, with a prevalence of about 20% [1] [2].…”

Section: Introductionmentioning

confidence: 99%

Extra-Pulmonary Tuberculosis in the Uterine Cervix: A Case Report

Kimera¹,

Sinyinza²,

Lukolo³

2022

CRCM

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Tuberculosis of the uterine cervix is grouped under genital tuberculosis. Other sites for genital tuberculosis include the Fallopian tubes and the endometrium. Genital tuberculosis and other types of tuberculosis outside the lungs are referred to as extra-pulmonary tuberculosis (EPTB). Genital tuberculosis presents with unspecific symptoms and signs; and because of this, most often, the diagnosis is made incidentally during investigations for other conditions that present with similar clinical pictures. Therefore, misdiagnosis and wrong treatment are not uncommon. We present a case of tuberculosis of the uterine cervix which was incidentally diagnosed when the patient was being investigated for cervical cancer, and successfully treated with a 6-months rifampicin regimen, 2RHZE/4HRE. Health providers have a duty to highly suspect tuberculosis of the cervix among women who present with abnormal vaginal discharge, abnormal vaginal bleeding and post-coital bleeding especially in countries where HIV and TB are endemic. If properly diagnosed and correctly treated, tuberculosis of the uterine cervix is curable.

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