Extrapulmonary Tuberculosis a Clinico-Epidemiological Perspective from a Tertiary Care Centre

Abstract

Introduction: Tuberculosis is a major global health problem. India accounts for one-fifth of the worldwide incidence of tuberculosis. The proportion of Extra-Pulmonary Tuberculosis among all TB cases varies from country to country. In India, Extra-Pulmonary tuberculosis accounted for 15%-20% of all forms of Tuberculosis. There are sparse data describing the epidemiology of Extra-Pulmonary Tuberculosis, hence this study was done in a tertiary care centre. Methodology: A retrospective longitudinal study was conducted at a tertiary care centre from 2012 to 2016. It included 297 consecutive patients aged>18 years, with a confirmed diagnosis of Extra-Pulmonary Tuberculosis. Demographics, clinical information, investigations, imaging, organ involvement, the mode of diagnosis and time to diagnosis were noted from medical records. Treatment offered and the outcome was analysed. Results: Mean age of the patients was 41 years with majority being young adults. The most common type of EPTB was TB Pleural effusion, followed by Spine and Meninges. The most common modality of diagnosis was Pleural aspiration followed by clinico-radiological and biopsy. The time taken for diagnosis of Skeletal TB was the longest. A total of 287 (96.63%) patients were initiated on anti-tuberculosis treatment after establishing the diagnosis. Conclusion: Early diagnosis of EPTB is challenging due to its atypical presentation. EPTB is prevalent even amongst those without immunocompromising conditions. The delay in diagnosis noted in this study is largely on account of patients presenting late to the hospital, thus making education and awareness programs for the general population imperative in bringing down morbidity and mortality associated with the condition.