tailieunhanh - Extrapulmonary tuberculosis

Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis (TB). The recent human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) pandemic has resulted in changing epidemiology and has once again brought extrapulmonary tuberculosis (EPTB) into focus. EPTB constitutes about 15 to 20 per cent of all cases of tuberculosis in immunocompetent patients and accounts for more than 50 per cent of the cases in HIV-positive individuals. Lymph nodes are the most common site of involvement followed by pleural effusion and virtually every site of the body can be affected. Since the clinical presentation of. | Review Article Indian J Med Res 120 October 2004 pp 316-353 Extrapulmonary tuberculosis . Sharma A. Mohan Department of Medicine All India Institute of Medical Sciences New Delhi Department of Emergency Medicine Sri Venkateswara Institute of Medical Sciences Tirupati India Received September 25 2003 Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis TB . The recent human immunodeficiency virus HIV and acquired immunodeficiency syndrome AIDS pandemic has resulted in changing epidemiology and has once again brought extrapulmonary tuberculosis EPTB into focus. EPTB constitutes about 15 to 20 per cent of all cases of tuberculosis in immunocompetent patients and accounts for more than 50 per cent of the cases in HIV-positive individuals. Lymph nodes are the most common site of involvement followed by pleural effusion and virtually every site of the body can be affected. Since the clinical presentation of EPTB is atypical tissue samples for the confirmation of diagnostic can sometimes be difficult to procure and the conventional diagnostic methods have a poor yield the diagnosis is often delayed. Availabiity of computerised tomographic scan magnetic resosnance imaging laparoscopy endoscopy have tremendously helped in anatomical localisation of EPTB. The disease usually responds to standard antituberculosis drug treatment. Biopsy and or surgery is required to procure tissue samples for diagnosis and for managing complications. Further research is required for evolving the most suitable treatment regimens optimal duration of treatment and safety when used with highly active antiretroviral treatmenrt HAART . Key words Abdominal tuberculosis - bone and joint tuberculosis - disseminated tuberculosis - extrapulmonary tuberculosis -genitourinary tuberculosis - laryngeal tuberculosis - lymph node tuberculosis - miliary tuberculosis - neurological tuberculosis -pericardial tuberculosis - .

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