Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance
Pathogenic <i>Mycobacterium tuberculosis</i> complex organisms (MTBC) primarily cause pulmonary tuberculosis (PTB); however, MTBC are also capable of causing disease in extrapulmonary (EP) organs, which pose a significant threat to human health worldwide. Extrapulmonary tuberculosis (EPT...
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MDPI AG
2021-05-01
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| Series: | Journal of Respiration |
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| Online Access: | https://www.mdpi.com/2673-527X/1/2/15 |
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| author | Radha Gopalaswamy V. N. Azger Dusthackeer Silambuchelvi Kannayan Selvakumar Subbian |
| author_facet | Radha Gopalaswamy V. N. Azger Dusthackeer Silambuchelvi Kannayan Selvakumar Subbian |
| author_sort | Radha Gopalaswamy |
| collection | DOAJ |
| description | Pathogenic <i>Mycobacterium tuberculosis</i> complex organisms (MTBC) primarily cause pulmonary tuberculosis (PTB); however, MTBC are also capable of causing disease in extrapulmonary (EP) organs, which pose a significant threat to human health worldwide. Extrapulmonary tuberculosis (EPTB) accounts for about 20–30% of all active TB cases and affects mainly children and adults with compromised immune systems. EPTB can occur through hematogenous, lymphatic, or localized bacillary dissemination from a primary source, such as PTB, and affects the brain, eye, mouth, tongue, lymph nodes of neck, spine, bones, muscles, skin, pleura, pericardium, gastrointestinal, peritoneum, and the genitourinary system as primary and/or disseminated disease. EPTB diagnosis involves clinical, radiological, microbiological, histopathological, biochemical/immunological, and molecular methods. However, only culture and molecular techniques are considered confirmatory to differentiate MTBC from any non-tuberculous mycobacteria (NTM) species. While EPTB due to MTBC responds to first-line anti-TB drugs (ATD), drug susceptibility profiling is an essential criterion for addressing drug-resistant EPTB cases (DR-EPTB). Besides antibiotics, adjuvant therapy with corticosteroids has also been used to treat specific EPTB cases. Occasionally, surgical intervention is recommended, mainly when organ damage is debilitating to the patient. Recent epidemiological studies show a striking increase in DR-EPTB cases ranging from 10–15% across various reports. As a neglected disease, significant developments in rapid and accurate diagnosis and better therapeutic interventions are urgently needed to control the emerging EPTB situation globally. In this review, we discuss the recent advances in the clinical diagnosis, treatment, and drug resistance of EPTB. |
| first_indexed | 2024-03-10T09:13:04Z |
| format | Article |
| id | doaj.art-84bfcda3cee74f7582ae458a07f3664f |
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| issn | 2673-527X |
| language | English |
| last_indexed | 2024-03-10T09:13:04Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Respiration |
| spelling | doaj.art-84bfcda3cee74f7582ae458a07f3664f2023-11-22T05:51:08ZengMDPI AGJournal of Respiration2673-527X2021-05-011214116410.3390/jor1020015Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug ResistanceRadha Gopalaswamy0V. N. Azger Dusthackeer1Silambuchelvi Kannayan2Selvakumar Subbian3Department of Bacteriology, National Institute for Research in Tuberculosis, Chennai 600031, IndiaDepartment of Bacteriology, National Institute for Research in Tuberculosis, Chennai 600031, IndiaDepartment of Bacteriology, National Institute for Research in Tuberculosis, Chennai 600031, IndiaPublic Health Research Institute, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ 07103, USAPathogenic <i>Mycobacterium tuberculosis</i> complex organisms (MTBC) primarily cause pulmonary tuberculosis (PTB); however, MTBC are also capable of causing disease in extrapulmonary (EP) organs, which pose a significant threat to human health worldwide. Extrapulmonary tuberculosis (EPTB) accounts for about 20–30% of all active TB cases and affects mainly children and adults with compromised immune systems. EPTB can occur through hematogenous, lymphatic, or localized bacillary dissemination from a primary source, such as PTB, and affects the brain, eye, mouth, tongue, lymph nodes of neck, spine, bones, muscles, skin, pleura, pericardium, gastrointestinal, peritoneum, and the genitourinary system as primary and/or disseminated disease. EPTB diagnosis involves clinical, radiological, microbiological, histopathological, biochemical/immunological, and molecular methods. However, only culture and molecular techniques are considered confirmatory to differentiate MTBC from any non-tuberculous mycobacteria (NTM) species. While EPTB due to MTBC responds to first-line anti-TB drugs (ATD), drug susceptibility profiling is an essential criterion for addressing drug-resistant EPTB cases (DR-EPTB). Besides antibiotics, adjuvant therapy with corticosteroids has also been used to treat specific EPTB cases. Occasionally, surgical intervention is recommended, mainly when organ damage is debilitating to the patient. Recent epidemiological studies show a striking increase in DR-EPTB cases ranging from 10–15% across various reports. As a neglected disease, significant developments in rapid and accurate diagnosis and better therapeutic interventions are urgently needed to control the emerging EPTB situation globally. In this review, we discuss the recent advances in the clinical diagnosis, treatment, and drug resistance of EPTB.https://www.mdpi.com/2673-527X/1/2/15lymph nodePCRmeningitislymphadenitispericarditiscutaneous |
| spellingShingle | Radha Gopalaswamy V. N. Azger Dusthackeer Silambuchelvi Kannayan Selvakumar Subbian Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance Journal of Respiration lymph node PCR meningitis lymphadenitis pericarditis cutaneous |
| title | Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance |
| title_full | Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance |
| title_fullStr | Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance |
| title_full_unstemmed | Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance |
| title_short | Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance |
| title_sort | extrapulmonary tuberculosis an update on the diagnosis treatment and drug resistance |
| topic | lymph node PCR meningitis lymphadenitis pericarditis cutaneous |
| url | https://www.mdpi.com/2673-527X/1/2/15 |
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