Extrapulmonary tuberculosis, clinical presentation and outcome

ABSTRACT

To identify patterns, features, and outcome of extrapulmonary tuberculosis in a tertiary care setting. A retrospective case-series was carried out of all cases diagnosed and treated as extrapulmonary tuberculosis during 1991 through to 2000 at King Faisal Specialist Hospital and Research Centre [KFSH and RC], Riyadh, Kingdom of Saudi Arabia. Demographic, clinical, laboratory, and outcome data were abstracted from medical records. Over a 10-year period, 394 cases of extrapulmonary tuberculosis were diagnosed and treated at KFSH and RC. Isolated extrapulmonary tuberculosis was identified in 339 [86%] patients, 55 cases [14%] had both pulmonary and extrapulmonary tuberculosis. Mean age was 45-years, and 188 patients [47%] had co-morbidities, most commonly diabetes mellitus in 14.2% of patients. Laboratory confirmation of extrapulmonary tuberculosis was available on 386 patients. The most frequent site involvement was lymphadenopathy in 41% of the time. Chest x-ray was normal in 75% of patients. Among 298 patients with follow up data, 10 [3.4%] had documented relapse and 50 [16%] died. Death was related to tuberculosis in 24 [48%] patients. A high level of clinical suspicion is essential for early diagnosis and treatment of extrapulmonary tuberculosis to reduce the significant morbidity and mortality