Clinical Spectrum of Tuberculosis

ABSTRACT

Being the second leading cause of mortality due to infectious diseases, the burden of tuberculosis is huge globally as well as in India. Therefore, timely diagnosis and treatment are essential to improve the clinical outcomes of the disease. It is therefore essential to create awareness and educate all concerned regarding the clinical spectrum of the disease which includes both pulmonary and extrapulmonary manifestations. Apart from typical systemic manifestations, depending on the organ affected infected patients may present with atypical signs and symptoms. The challenge is establishing definitive diagnosis in absence of discrete symptoms. Also, the EPTB generally are insidious in onset and diagnosis usually occurs in advanced stages. Therefore, a high index of suspicion is necessary particularly in absence of fever, weight loss and fatigue to avoid delay in diagnosis and thereby reduce risk of complications. It is worth mentioning that apart from high-risk individuals with HIV, chronic kidney failure, poor glycemic control, patients being treated with immunosuppressants, and both pediatric and geriatric populations who are immunocompromised, TB can be reactivated and EPTB can occur regardless of the individuals’ immune status. This review article elucidates different clinical presentations of patients with both pulmonary and extra-pulmonary TB which may facilitate early management even in settings with lack of advanced diagnostic evaluation or additionally offer a right direction to perform appropriate investigations