Understanding Tuberculosis Variants: Key Facts to Remember
Article Title: Understanding Extrapulmonary Tuberculosis: Symptoms, Diagnosis, and Types
Tuberculosis (TB) is a bacterial infection primarily transmitted through the air, and while it is often associated with the lungs, it can affect various other parts of the body, known as extrapulmonary TB.
Symptoms and Affected Sites
Common symptoms of extrapulmonary TB vary depending on the organ involved but often include general systemic signs such as fever, night sweats, weight loss, fatigue, and loss of appetite. Specific symptoms reflect the affected site.
For instance, lymph nodes affected by TB may present as swollen, painless lumps. Pleural TB, which involves the lining of the lungs, can cause chest pain, dry cough, fever, shortness of breath, and headache. Central nervous system involvement may lead to headache, neurological deficits, and confusion. Bones and joints might show localized pain, swelling, and reduced movement, while genitourinary TB can cause urinary symptoms and pelvic pain.
Diagnosis
Diagnosis of extrapulmonary TB involves a combination of clinical assessment, imaging studies, microbiological tests, histopathology, immunological tests, and biopsy, if necessary. Clinical assessment is based on symptoms and history, while imaging studies like chest X-rays, CT scans, or MRI help detect organ involvement.
Microbiological tests involve sampling and staining/culture/PCR of tissue, fluids, or biopsy samples for Mycobacterium tuberculosis. Histopathology shows granulomatous inflammation, and immunological tests like the tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) support diagnosis but cannot differentiate latent from active disease.
Types of Extrapulmonary TB
Extrapulmonary TB manifestations differ widely, and diagnosis often requires high clinical suspicion and tailored testing depending on symptoms and site involved. Types of extrapulmonary TB include gastrointestinal TB, skeletal TB, liver TB, and more.
Gastrointestinal TB is rare in the intestines, and Miliary TB appears as millet-seed-like lesions on the lungs and other organs in the body, affecting the blood, bones, lymphatic system, central nervous system, or organs.
Rare Forms of TB
Cutaneous TB affects the skin and is a rare form of TB, accounting for about one-third of all extrapulmonary TB cases. It can appear as any type of skin lesion, such as papules, nodules, ulcers, pustules, or verrucous plaques.
Bladder TB usually occurs after a TB infection in the kidneys, and liver TB usually affects those with an advanced HIV infection or other immunodeficiency.
Other Forms and Complications
TB meningitis is an infection of the meninges, the membranes covering the spinal cord and brain, and TB pericarditis affects the pericardium, the membrane surrounding the heart. TB peritonitis affects the peritoneum, the lining of the abdomen, and usually occurs alongside other types of abdominal TB.
TB lymphadenitis is the most common form of extrapulmonary TB and affects the lymph nodes. TB meningitis causes symptoms of meningitis, including headache, fever, change in mental status, and facial palsy. TB peritonitis may cause ascites, a buildup of fluid in the abdomen.
Active TB and Latent TB
Active TB causes symptoms and is contagious, and doctors refer to it as TB disease. On the other hand, latent TB occurs when the TB bacteria are inactive within a person's body and do not cause symptoms or spread to others. Latent TB can become active TB if the immune system weakens.
Conclusion
Extrapulmonary TB, while less common, can present with a wide range of symptoms and require careful diagnosis. Understanding the various types and symptoms of extrapulmonary TB can help in early detection and treatment, improving the chances of recovery.
- In addition to affecting the lungs, tuberculosis (TB) can also lead to chronic diseases like nervous system disorders, causing headache, neurological deficits, and confusion.
- The medical-conditions associated with extrapulmonary TB can manifest in various forms, such as skin-conditions like cutaneous TB, appearing as any type of skin lesion, or neurological-disorders such as TB meningitis.
- Skin-care is essential for individuals diagnosed with cutaneous TB, which is a rare form of TB accounting for about one-third of all extrapulmonary TB cases.
- Certain medical-conditions such as HIV infection or other immunodeficiencies increase the risk of developing liver TB or bladder TB, which usually occurs after a TB infection in the kidneys.
- Beyond the lung area, TB can affect various other organs, causing complications like TB lymphadenitis, TB meningitis, TB pericarditis, TB peritonitis, and more, which require tailored diagnosis and treatment.
