[Extrapulmonary tuberculosis]. / Tuberculosis extrapulmonar, una revisión.

Up to 25% of tuberculosis cases present extrapulmonary involvement. This is produced by haematogenous and lymphatic spread of the M. tuberculosis bacillus to other organs. The most common locations are the lymph nodes, pleura and the osteoarticular system. The problem with these types of tuberculosis is the difficulty in establishing a definitive diagnosis, since the clinical symptoms and results of imaging tests may be vague. It is often necessary to resort to invasive diagnostic testing such as ultrasound or CAT-guided FNAB, used to collect biological samples for diagnosis. Despite the growing use of and advances in recent years of molecular methods for early detection of mycobacteria DNA, cultures continue to be the gold standard that enable a firm microbiological diagnosis to be made. Treatment for these types of tuberculosis do not differ from treatment regimens for pulmonary forms of the same disease. The same antibiotic regimens for 6 months are recommended, and any extension of this period is advisable solely in tuberculosis affecting the central nervous system and in Pott's disease.

Tuberculosis extrapulmonar, una revisión / Extrapulmonary tuberculosis

Hasta en un 25% de los casos de tuberculosis existe afectación extrapulmonar. Esta afectación es producida por la diseminación hematógena y linfática del bacilo de M. tuberculosis hacia otros órganos. Las localizaciones más frecuentes son la ganglionar, pleural y osteo-articular. El problema de estas formas de tuberculosis radica en la dificultad para llegar a su diagnóstico definitivo, ya que tanto los síntomas clínicos, como las pruebas de imagen pueden ser inespecíficos. La mayoría de las veces es necesario recurrir a pruebas diagnósticas invasivas como PAAF guiada con ecografía o TAC, para la recolección de muestras biológicas para su diagnóstico. A pesar del auge y el avance, en los últimos años, de los métodos moleculares para la detección precoz de ADN de la micobacteria, el cultivo sigue siendo el gold estándar que permite el diagnóstico microbiológico definitivo. El tratamiento de estas formas de tuberculosis, no va diferir de las pautas de tratamiento de las formas pulmonares. Se recomienda utilizar los mismos regímenes de antibióticos con una duración de 6 meses y únicamente prolongar la duración en las tuberculosis con afectación del sistema nervioso y en la espondilitis tuberculosa con afectación neurológica (AU)

Up to 25% of tuberculosis cases present extrapulmonary involvement. This is produced by haematogenous and lymphatic spread of the M. tuberculosis bacillus to other organs. The most common locations are the lymph nodes, pleura and the osteoarticular system. The problem with these types of tuberculosis is the difficulty in establishing a definitive diagnosis, since the clinical symptoms and results of imaging tests may be vague. It is often necessary to resort to invasive diagnostic testing such as ultrasound or CAT-guided FNAB, used to collect biological samples for diagnosis. Despite the growing use of and advances in recent years of molecular methods for early detection of mycobacteria DNA, cultures continue to be the gold standard that enable a firm microbiological diagnosis to be made. Treatment for these types of tuberculosis do not differ from treatment regimens for pulmonary forms of the same disease. The same antibiotic regimens for 6 months are recommended, and any extension of this period is advisable solely in tuberculosis affecting the central nervous system and in Pott’s disease (AU)