Form Of Extrapulmonary Tuberculosis Research Articles

Characteristics of Patients with Tuberculous Pleural Effusion in Rural Nepal


 Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. TubercularPleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal.
 
 Methods: A retrospective study was conducted with all the cases diagnosed and admitted with pleural effusion at Lumbini Medical College And Teaching Hospital from April 2011 to March 2013 of all the cases diagnosed andadmitted with pleural effusion were included in the study. Hundred cases diagnosed with pleural effusion by clinical Examination or chest X-ray or ultrasonography’s (USG) of the chest were included in the studied. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21.
 
 Results: Out of 100 cases, the cause of pleural effusion in 59 patients was tuberculosis, 14 by malignancy, next 14 by Para pneumonic Effusion, 12 by congestive cardiac failure and three cases by alcoholic liver disease. Patients with tuberculous pleural effusion were younger, predominantly males, had unilateral effusion, lower blood hemoglobin, lower Pleural fluid neutrophils, higher pleural fluid Adenosine Deaminase (ADA) levels and higher level of pleural fluid to serum protein ratio as compared to the patients with non-tuberculous effusion.
 
 Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal.

English

INTRODUCTION: Tuberculosis is the most common HIV-related opportunistic infection in India, and caring for patients with both diseases is a major public health challenge, which places an immense burden on health care systems and poses particular diagnostic and therapeutic challenges, increasing the risk of treatment failure, relapse and death. Estimates by the World Health Organization (WHO) indicate that there are more than 9 million new active cases of TB and close to 2 million deaths per year. MATERIALS AND METHOD: The present retrospective study was conducted for a period of one year. HIV status was confirmed for patients attending voluntary counselling and testing centre (VCTC). HIV positive patients were referred to designated microscopic centre (DMC) for sputum examination for AFB and ART centre for estimation of CD4 count and necessary relevant investigations were carried out for extrapulmonary tuberculosis (EPTB). RESULTS: Out of 682 HIV positive patients, 93(13.6%) cases were diagnosed with pulmonary tuberculosis. Extrapulmonary tuberculosis was detected in16 (2.3%) patients. The commonest form of EPTB was cervical adenitis detected in13 (1.9%) of cases and pleural effusion in 3 (0.4%) of cases respectively. The mean CD4 count was 208 cells/µl in patients with pulmonary tuberculosis (PTB) and 192cells /µl , 162 cells /µl in patients with cervical adenitis and pleural effusion. CONCLUSIONS: Further reduction of CD4 count occurs in dually infected patients. Early diagnosis and prompt institution of ART and ATT reduces mortality and morbidity significantly. INTRODUCTION: Tuberculosis (TB) and human immunodeficiency virus (HIV) constitute the main burden of infectious disease in resource-limited Countries 1 . Persons infected with HIV are particularly susceptible to tuberculosis, both from the reactivation of latent infection and from new infection with rapid progression to active disease 2 . An individual who is HIV-positive has 10 times increased risk of developing TB compared to an HIV-negative person the life time risk is 50% for an HIV-positive person and 5-10% for an HIV-negative person3. Estimates by the World Health Organization (WHO) indicate that there are more than 9 million new active cases of TB and close to 2 million deaths per year and that 2.6 million new cases of HIV infection and 1.8 million AIDS- related deaths occur per year 1 . In India alone about 2.5 million people are currently infected with

Tuberculous lymphadenitis of the neck: Case series

Tuberculous lymphadenitis is the most common form of extra pulmonary tuberculosis and cervical lymph nodes constitute the most common site of involvement. The proportion of extra pulmonary patients has been increasing for the last two decades. Presented are 3 consecutive female patients aged 32, 50, and 68 years that presented to a surgical unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Two patients presented with lesions located in the anterior triangle of the neck, while the third had bilateral lesions located in the posterior triangle of the neck. All were referrals without prior diagnosis of tuberculosis. Diagnosis was by cytology and histology. Notable associations were miliary tuberculosis and anaemia. Provision of appropriate and effective prevention modalities, diagnostic facilities, and effective surveillance from the primary to the tertiary health facilities for early detection and treatment of the disease is advocated.

Spinal Tuberculosis

Spinal tuberculosis (TB), a destructive form of extrapulmonary TB, is uncommon in the United States. It is more common among immigrants from TB-endemic countries. Typically, the infection spreads to the vertebrae from a primary site elsewhere. Spinal TB commonly presents with an insidious onset of nonspecific back pain and can be the first presenting symptom of underlying TB. Because it presents in a similar fashion to a metastatic disease, which is more common in the United States, a diagnosis of spinal TB is often delayed, resulting in long-term disability. A high clinical suspicion coupled with appropriate imaging studies helps in prompt diagnosis and the rapid institution of treatment. Anti-TB drugs are effective to treat spinal TB, but surgery is required in refractory disease, abscess formation, vertebral collapse, and/or nerve compression. We present 2 cases of spinal TB: one responded very well to medical treatment; the other required adjunct surgery.

The burden of extrapulmonary and meningitis tuberculosis: an investigation of national surveillance data, Germany, 2002 to 2009

Tuberculosis (TB) surveillance commonly focuses on pulmonary (PTB) where the main organ affected is the lung. This might lead to underestimate extrapulmonary TB (EPTB) forms, where in addition to the lung other sites are affected by TB. In Germany, TB notification data provide the main site and the secondary site of disease. To gain an overview of all the different EPTB forms, we analysed German TB notification data between 2002 and 2009 using information on both main and secondary disease site to describe all individual EPTB forms. Further, we assessed factors associated with meningitis using multivariable logistic regression. Solely analysing the main site of disease, lead to one third of EPTB manifestations being overlooked. Case characteristics varied substantially across individual extrapulmonary forms. Of 46,349 TB patients, 422 (0.9%) had meningitis as main or secondary site. Of those, 105 (25%) of the 415 with available information had died. Multivariable analysis showed that meningitis was more likely in children younger than five years and between five and nine years-old (odds ratio (OR): 4.90; 95% confidence interval (CI): 3.40–7.07 and OR: 2.65; 95% CI: 1.40–5.00), in females (OR: 1.42; 95% CI: 1.17–1.73), and in those born in the World Health Organization (WHO) regions of south-east Asia (OR: 2.38; 95% CI: 1.66–3.43) and eastern Mediterranean (OR: 1.51; 95% CI: 1.02–2.23). Overall, EPTB manifestations, including meningitis, which is often fatal, were underestimated by routine analysis. We thus recommend using all information on disease manifestation generated by surveillance to monitor severe forms and to transfer the gained knowledge to TB case management where awareness of EPTB is most important.

Expansion of Pathogen-Specific Mono- and Multifunctional Th1 and Th17 Cells in Multi-Focal Tuberculous Lymphadenitis

BackgroundTh1 and Th17 responses are known to play an important role in immunity to pulmonary tuberculosis (PTB), although little is known about their role in extrapulmonary forms of tuberculosis (TB).MethodsTo identify the role of Th1, Th17, and Th22 cells in multi-focal TB lymphadenitis (TBL), we examined mycobacteria–specific immune responses in the whole blood of individuals with PTB (n = 20) and compared them with those with TBL (n = 25).ResultsElevated frequencies of CD4+ T cells expressing IFN- γ, TNF-α, and IL-2 were present in individuals with TBL compared with those with PTB at baseline and in response to ESAT-6 and CFP-10. Similarly, increased frequencies of CD4+ T cells expressing IL-17A, IL-17F, and IFN-γ were also present in individuals with TBL at baseline and following ESAT-6 and CFP-10 stimulation although no significant difference in frequency of Th22 cells was observed. Finally, frequencies of Th1 (but not Th17) cells exhibited a significantly negative correlation with natural regulatory T cell frequencies at baseline.ConclusionsMulti-focal TB lymphadenitis is therefore characterized by elevated frequencies of Th1 and Th17 cells, indicating that Th1 and Th17 responses in TB disease are probably correlates of disease severity rather than of protective immunity.

Mapping the pattern and trends of extrapulmonary tuberculosis

Background and Objectives:There has been a rapid expansion of the directly observed treatment short-term (DOTS) under the revised national tuberculosis control program throughout India in the last decade. Few reports exist detailing individual DOTS centers’ experiences with regard to extrapulmonary tuberculosis (EPTB) in a medical college hospital setting.Materials and Methods:This is a retrospective, record-based study of patients with the diagnosis of EPTB, in all age groups. Data on all consecutive EPTB cases diagnosed at the K. S. Hegde Medical College and Hospital, Deralakatte, Mangalore from 1 January 2005 to 31 December 2011 at the DOTS centre attached to this hospital were collected, analyzed by Mantel-Haenszel Chi square for linear trend and described in proportion or percentages.Results:Among 1267 cases registered for treatment of all forms of tuberculosis, 528 (41.67%) had EPTB. Around half of the cases of EPTB (269, 51%) were among adult age groups and the majority of cases (342, 64.77%) received Category-I treatment. Pleural TB was the commonest type of EPTB (n = 148, 28.03%), followed by lymph node TB (n = 131, 24.81%). Involvement of lymph nodes was the commonest manifestation among the less than 14 years’ age group (27, 58.7%), while involvement of pleura was more common among > 65 years’ age group (23, 45.1%). The difference in the occurrence of EPTB by site between males and females is statistically significant with a P value of <0.005. There is a significant increase in the number of cases of tuberculosis affecting bones and joints, and other forms of tuberculosis over the years.Conclusion:The burden of EPTB is more among the productive age group. Increase in the trend of bone and joint tuberculosis, and other rare forms of EPTB is a point of concern highlighting the importance of strengthening the services towards this group.

Kidney and Tuberculosis

Genitourinary tuberculosis is the second most common form of extrapulmonary tuberculosis after lymph node involvement. It can involve any part of the genitourinary system and presentation may vary from vague urinary symptoms to chronic kidney disease. The kidney is usually the primary organ infected in the genitourinary system and renal involvement of tuberculosis often does not present with classic symptoms of fever, weight loss, or night sweats. Tuberculosis of the urinary tract is, therefore, easily overlooked. In patients with a diagnosis of genitourinary tuberculosis, only 10% show signs of active pulmonary tuberculosis and the latency period between the initial tuberculosis infection and diagnosis with renal disease may be as long as 5–40 years. Direct infection of the kidney and lower urinary tract, and secondary amyloidosis are major forms of well-documented renal involvement. However, in recent years, an increasing number of data have reported that, independent of drug therapy, tuberculosis itself can cause glomerular and tubulointerstitial lesions, and patients may present with either acute or chronic renal failure with proteinuria. The most frequent renal biopsy finding in patients with renal involvement is chronic tubulointerstitial nephritis. Progression to end-stage renal failure may be higher than currently believed because there is little evidence as to the extent to which tuberculosis is a cause of end-stage renal failure worldwide. Tuberculosis should be considered as a possible origin of both acute and chronic renal failure, especially in countries where the incidence of tuberculosis is high. Timely diagnosis and treatment may prevent acute forms of renal disease and late sequelae of pulmonary tuberculosis. Kidney biopsy should be considered in the clinical evaluation of kidney dysfunction with tuberculosis and also in cases with unusual presentations.

Diagnosis of extrapulmonary tuberculosis by PCR

During the last two decades, the resurgence of tuberculosis (TB) has been documented in both developed and developing nations, and much of this increase in TB burden coincided with human immunodeficiency virus (HIV) epidemics. Since then, the disease pattern has changed with a higher incidence of extrapulmonary tuberculosis (EPTB) as well as disseminated TB. EPTB cases include TB lymphadenitis, pleural TB, TB meningitis, osteoarticular TB, genitourinary TB, abdominal TB, cutaneous TB, ocular TB, TB pericarditis and breast TB, although any organ can be involved. Diagnosis of EPTB can be baffling, compelling a high index of suspicion owing to paucibacillary load in the biological specimens. A negative smear for acid-fast bacilli, lack of granulomas on histopathology and failure to culture Mycobacterium tuberculosis do not exclude the diagnosis of EPTB. Novel diagnostic modalities such as nucleic acid amplification (NAA) can be useful in varied forms of EPTB. This review is primarily focused on the diagnosis of several clinical forms of EPTB by polymerase chain reaction (PCR) using different gene targets.

Primary abdominal tuberculosis presenting as peritonitis in a young child–managed surgically

Abdominal tuberculosis (TB) is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. We are presenting a rare case in a young female of age 7 year diagnosed as peritonitis and intestinal obstruction. Operative findings revealed dense fibrosis in interloops and perforation of the small bowel. She was put on antitubercular treatment for one year. Patient was discharged in satisfactory condition and is in follow up for 2 months.

Site of Extrapulmonary Tuberculosis is Associated with HIV Infection

In the United States, the proportion of patients with extrapulmonary tuberculosis (EPTB) has increased relative to cases of pulmonary tuberculosis. Patients with central nervous system (CNS)/meningeal and disseminated EPTB and those with human immunodeficiency virus (HIV)/AIDS have increased mortality. The purpose of our study was to determine risk factors associated with particular types of EPTB. We retrospectively reviewed 320 cases of EPTB from 1995-2007 at a single urban US public hospital. Medical records were reviewed to determine site of EPTB and patient demographic and clinical characteristics. Multivariable logistic regression analyses were performed to determine independent associations between patient characteristics and site of disease. Patients were predominantly male (67%), African American (82%), and US-born (76%). Mean age was 40 years (range 18-89). The most common sites of EPTB were lymphatic (28%), disseminated (23%), and CNS/meningeal (22%) disease. One hundred fifty-four (48.1%) were HIV-infected, 40% had concomitant pulmonary tuberculosis, and 14.7% died within 12 months of EPTB diagnosis. Multivariable analysis demonstrated that HIV-infected patients were less likely to have pleural (adjusted odds ratio [AOR] 0.3; 95% confidence interval [CI] .2, .6) as site of EPTB disease than HIV-uninfected patients. Among patients with EPTB and HIV-infection, patients with CD4 lymphocyte cell count <100 were more likely to have severe forms of EPTB (CNS/meningeal and/or disseminated) (AOR 1.6; 95% CI, 1.0, 2.4). Among patients hospitalized with EPTB, patients coinfected with HIV and low CD4 counts were more likely to have CNS/meningeal and disseminated disease. Care for similar patients should include consideration of these forms of EPTB since they carry a high risk of death.

Empfehlungen zur Therapie, Chemoprävention und Chemoprophylaxe der Tuberkulose im Erwachsenen- und Kindesalter

Several new international recommendations have been published since the German Central Committee against Tuberculosis (DZK) published its recommendations for drug treatment of tuberculosis (TB) in 2001 and for chemoprevention of latent tuberculosis infection (LTBI) in 2004. These international publications have been integrated in the present new recommendations which describe both the treatment of active TB and preventive treatment, pointing out specific adaptations for Germany. Separate sections deal with the current management of mono-, poly-, and multiresistance or drug intolerance, of TB in children, of different forms of extrapulmonary TB, of LTBI and of special situations such as HIV infection, renal or hepatic insufficiency, infection following BCG instillation in bladder cancer or in case of adverse drug reactions. The following aspects differ from the previous recommendations: A three-drug regimen for the so-called fully susceptible minimal TB is no longer recommended in adults. A dosage of 15 mg/kg body weight of ethambutol for adults is regarded as sufficient. Four secondline drugs (supplemented by pyrazinamide, where appropriate) are recommended for multidrug-resistant tuberculosis (MDR-TB). MDR-TB should be treated over a period of at least 20 months, with an injectable drug administered for a minimum of 8 months (initial phase). Ciprofloxacine and ofloxacine are no longer used to treat TB. It is also recommended to offer an HIV test to all TB patients to complement antiretroviral therapy, if necessary, and to adapt the antituberculous therapy accordingly.

Tuberculosis of Thyroid Gland - A Rare Case Report

Tuberculosis of thyroid gland is a very rare condition even though the incidence of extra pulmonary forms of tuberculosis is increasing. According to literature, frequency of thyroid tuberculosis is 0.1%–0.4%. We report a case of 66year old female patient with primary tuberculosis of thyroid gland. The diagnosis was established on histopathological examination after surgery. Patient underwent combination treatment with anti-tubercular chemotherapy

HIV-Associated Tuberculosis 2012

Tuberculosis (TB) is an important public health problem and remains a leading cause of death in low- and middle-income countries, with an estimated 9.27 million new cases and 1.7 million deaths worldwide in 2007. HIV infection is the greatest risk factor for developing TB. The devastating association between HIV and TB means that 1.37 million of the new TB cases were amongst HIV-infected people and one out of four TB deaths was HIV related in 2007. The risk of TB is increased during all stages of HIV infection from about 10% over a lifetime (in HIV-uninfected individuals) to as high as 30% per annum in patients with advanced HIV. This special issue addresses several important aspects of the clinical presentation and management, diagnosis, and immunology of HIV-associated TB. Combination antiretroviral therapy (cART) has progressively decreased mortality of HIV-associated tuberculosis patients worldwide. However, despite the increasing roll out of antiretroviral therapy (ART), the number of deaths attributable to TB still remains high in some parts of the world. The paper by T. T. Liu et al. highlights this fact and the discrepancies between TB-attributed hospital deaths and the diagnostically confirmed TB deaths, emphasizing the difficulties of diagnosing TB in a high HIV prevalence setting in routine hospital care. The paper by E. Girardi et al. examined TB treatment outcomes in HIV-infected patients diagnosed with TB in Italy. ART during TB treatment was associated with substantial reduction of death rate, while patients who were not ART naive when they developed TB had an elevated risk of death. HIV-infected patients are more likely to develop extrapulmonary forms of TB, such as pleural TB. While pleural TB in the immune competent host may be a self-limiting disease, it provides formidable challenges to clinicians around the world in the context of HIV. The systematic review by A. Aljohaney et al. summarises the epidemiology, the immunopathogenesis, and the challenges associated with diagnosis and treatment of pleural TB in HIV-infected patients. The high rate of latent TB infection is the main challenge to achieving global control of TB. The introduction of IGRA has greatly facilitated diagnosis of LTBI in the developed countries; however, the difficulty in developing countries and HIV-infected individuals remains. The antibody response to tubercular glycolipid (TBGL) antigen was shown to be a promising serodiagnostic agent in Japan, and the paper by U. R. Siddiqi et al. evaluates the antibody response against this antigen in health care workers and HIV-infected individuals in the Philippines. Chronic HIV infection leads to excessive production of proinflammatory cytokines which leads to the generation of free radicals which are in turn scavenged by free glutathione. Thus the excessive production of free radicals in HIV-infected individuals or reduced glutathione synthesis may lead to the depletion of glutathione. D. Morris et al. examined the causes for decreased glutathione in individuals with chronic HIV infection and found lower levels of intracellular glutathione in macrophages and increased levels of free radicals, interleukin-1 (IL-1), interleukin-17 (IL-17), and transforming growth factor-β (TGF-β) in plasma samples. They also found reduced expression of enzymes responsible for glutathione synthesis. These findings may contribute to the loss of immune function observed in chronic HIV infection. K. A. Wilkinson M. E. Torok S. Schwander G. Meintjes

A Case Report of Bilateral Tuberculosis of Breast

Tuberculosis of the breast is an extremely rare form of extra-pulmonary tuberculosis. Bilateral involvement is even rarer. We report a case of secondary bilateral breast tuberculosis in a young female, who responded to first line anti-tuberculosis drugs.

Genitourinary Tuberculosis: An Atypical Clinical Presentation

Genitourinary tuberculosis is one of the common forms of extrapulmonary tuberculosis. We report a case of atypical genitourinary tuberculosis: massive uterovaginal prolapse with cervical lesion mimicking cervical carcinoma. This particular case highlights the problem of healthcare in most of the developing countries. Lack of patient education, awareness, and access to a healthcare system resulted in a complicated situation. In an endemic area or in an immunocompromised individual, a higher index of suspicion would allow early recognition and treatment institution to minimise its late consequences as well as spreading of the disease. Though anti-TB is the mainstay of treatment, surgical intervention might be needed in selected cases.

Late diagnosis and TCD8 immune response profile of cutaneous tuberculosis: A case report

Introduction: Cutaneous tuberculosis (CTB) is a rare form of extra-pulmonary tuberculosis that, when associated with late diagnosis, worsen the quality of life of the sick individuals. This report presents a case of late diagnosis of CTB. Unusual clinical manifestations retarded the correct tuberculosis diagnosis for more than a year. The immune response elicited by this type of tuberculosis as well as the factors that might contribute to the delay in diagnosis was evaluated and discussed. Methodology: Clinical evaluation and flow cytometric analyses of PBMC were realized for a case of CTB and a healthy individual as a control. Results: M. tuberculosis specific TCD8+ cell response was analyzed by flow cytometry and revealed positive cells for IL-17, IL-10, TGF-β and IDO. The CTB patient presented higher percentage of those cells when compared to a healthy donor. However, TCD8 cells positive for the important protective cytokine, IFN-γ was decreased in the CTB patient. Conclusion. The assessment of the M. tuberculosis specific TCD8+ immune response showed a regulatory/modulatory phenotype with a reduced IFN-γ response when compared to the healthy control that could have contributed to the CTB infection.

Unique CYP3A4 genetic variant in Brazilian tuberculosis patients with/without HIV

CYP3A4 is involved in tuberculosis (TB) and human immunodeficiency virus (HIV) drug metabolism. Transcriptional activation by rifampicin involves the CYP3A4 gene 5'-upstream region. Consequently, variation may interfere with transcription and enzymatic activity and even drug response. However, genetic polymorphisms and distribution of CYP3A4 allelic frequencies in individuals from Rio de Janeiro remain unknown. The aim of this study was to conduct research into sequencing the CYP3A4 5'-upstream region in Brazilian patients with and without HIV. This follow-up study involved 106 individuals undergoing treatment for TB and/or HIV. The CYP3A4 5'-upstream region was analyzed using PCR, sequencing and clinical data. Male patients revealed a higher HIV frequency (p=0.021). The TB forms observed were pulmonary (48.1%), extrapulmonary (22.64%) and disseminated (27.36%). Lymph node form was the most frequent (70.83%) extrapulmonary form of TB. The only single nucleotide polymorphism detected in the population was c.-392A>G. Genotypes observed were CYP3A4*1A/CYP3A4*1A (45.3%), CYP3A4*1A/CYP3A4*1B (40.6%) and CYP3A4*1B/CYP3A4*1B (14.2%), revealing a different distribution with extrapulmonary TB cases (17.6% CYP3A4*1A/CYP3A4*1B and 23.5% CYP3A4*1B/CYP3A4*1B). The CYP3A4*1A allele was found to be associated with tobacco use. The CYP3A4*1B mutant allele occurred in 34% of patients. This study revealed that the CYP3A4 5'-upstream regulatory region was highly conserved with the exception of the -392 position. Genotype association with tobacco suggests that CYP3A4 may participate in tobacco metabolism. Genotype distribution inversion in extrapulmonary TB cases suggests that CYP3A4 may be involved in TB prognosis.

A case of lupus vulgaris with rare localization diagnosed 30 years after onset

Cutaneous tuberculosis (tuberculosis cutis) is one of the extrapulmonary forms of tuberculosis, which may affect the skin only or co-exist with tuberculosis of other organs, particularly the lungs. We describe a case of lupus vulgaris in a 72-year-old male patient with a single lesion localized on his lower extremity, developing for 30 years before correct diagnosis and previously treated with topical steroids. Bacillus infection in other organs was not detected. Diagnosis of tuberculosis was made based on personal history, clinical picture, hypersensitivity to tuberculin, histopathology and polymerase chain reaction. A multidrug therapy with rifampicin, isoniazid and pyrazinamide resulted in regression of the lesion. The common lack of knowledge about the clinical picture of cutaneous tuberculosis causes its late diagnosis and treatment.

Genetic association study suggests a role for SP110 variants in lymph node tuberculosis but not pulmonary tuberculosis in north Indians

Ethnic specificity is a key determinant in understanding the association of genetic variants with outcome of disease susceptibility. SP110, a component of the nuclear body, has been subjected to association studies with conflicting results. In this study we probed SP110 variants in pulmonary (PTB) and lymph node tuberculosis (LNTB) cases to explore their role in controlling susceptibility to Mycobacterium tuberculosis infection in north Indians. We genotyped 24 SP110 variants in over 140 north Indian tuberculosis cases and 78 ethnicity-matched controls. The SP110 gene variants were available from public databases. The cases and controls were free of any population stratification when subjected to Eigenstrat principal component analysis. Genotyping was carried out using the Sequenom MassARRAY platform. Applying exclusion criteria, 11 single nucleotide polymorphisms (SNPs) of the LNTB panel and 13 SNPs of the PTB panel passed all filters and were analyzed further. No significant association was observed between SP110 variants and PTB. Surprisingly, we discovered evidence of an association of SP110 variants with LNTB, a form of extrapulmonary tuberculosis, at 3 loci, namely, rs6436915, rs1427294, and rs1346311. When permutations analysis ( n = 10,000) of allelic p values was undertaken, only rs1427294 passed the test with its p value remaining statistically significant. The C allele of rs1427294 exhibited a 5-fold risk of developing LNTB. No significant haplotypes were observed. In the pilot study presented here, our results provide evidence for the first time that SP110 may be a risk determinant locus in LNTB while confirming a doubtful role of SP110 in PTB in north Indians. In general, the results might indicate a role of SP110 variants in extrapulmonary tuberculosis rather than PTB.