Tuberculosis extrapulmonar. Formas clínicas en pacientes en situaciones especiales

Abstract

The term extrapulmonary tuberculosis is used to describe M. tuberculosis infection of any organ without demonstrated pulmonary involvement. On occasion, simultaneous pulmonary and extrapulmonary infection occurs, in which case it is classified as pulmonary tuberculosis. It represents 20% of all tuberculosis cases worldwide. Its incidence has increased since the 1980s as a result of HIV infection. The most frequently affected areas are the pleura, lymph nodes, kidney and urinary tracts, bones and joints, central nervous system (CNS), and abdomen. Symptoms will depend on the organ involved. It is always necessary to rule out concomitant lung infection. In order to diagnose it, the existence of mycobacteria must be demonstrated through staining, cultures, or nucleic acid amplification techniques in samples obtained via puncture or biopsy. It can also be diagnosed by means of caseating granulomas with central caseous necrosis. Treatment is generally the same as that of pulmonary tuberculosis except when there is CNS or bone and joint involvement, which require a longer treatment time. When there is CNS involvement, glucocorticoids must also be administered.