Publication:

Extrapulmonary tuberculosis: Are we barking up the wrong tree? A 4 year naturalistic follow up study

Background Aim of the study was to determine if extra-pulmonary tuberculosis (EPTB) is a communicable disease as commonly perceived or a disease of host immune dysfunction.

Methods Patients with clinical suspicion of EPTB, in general surgery and orthopaedic department of twin hospitals of Deccan College of Medical Sciences, between the period of January 2015 and December 2017, were investigated appropriately and those found to have confirmed TB were enrolled in the study and followed up for 1 year.Simultaneously patient’s details registered under RNTCP in the two local community health centres were collected and compared with the hospital based study.

Results Of 319 patients with clinical features, 267 were confirmed with EPTB- maximum number with lymph nodal disease (127) followed by extremity bone and joint (63), spine (38), skin and soft tissues (25) and abdominal tb (19). Method of confirmation differed for each site. Detection by AFB being the least sensitive followed by AFB culture. The best method of diagnosis being histopathological examination.

Conclusions Immunity plays a major role in site of reactivation of TB and healing of disease irrespective of duration of anti-tuberculous chemotherapy or surgical intervention.