Tuberculosis extrapulmonar en nuestro medio: Formas de presentación

Abstract

Objetive: To analyse the distribution of the extrapulmonary forms of presentation of tuberculosis (EFP) in our health district. Materials and methods: The medical records of patients diagnosed with extrapulmonary tuberculosis attending the Tuberculosis Prevention and Control Unit of the Santiago Health District were reviewed over a three years period. The classification of EFP was: extrapulmonary forms (EF), disease outside the lung; mixed forms (MF), the presence of both pulmonary and extrapulmonary tuberculosis; disseminated forms (DF), the pressence of two or more extrapulmonary locations; and miliary TB, which was definied by a diffuse pulmonary radiographic pattern or diag - nosis was undertaken by necropsy. Results: A total of 921 tuberculosis infected patients were observed, of which 370 (40.2%) were extrapulmonary forms; of these, 199 were men and 171 women (mean age was 36.9 years, range 19-68). The distri - bution of EFP was: 307 EF (83%) of which 140 (45.6%) were pleural, 87 (28.3%) ganglionary, 16 (5.2%) intestinal, 14 (4.5%) bone and joint, 11 (3.6%) genitourinary, 11 (3.6%) cutaneous, 10 (3.3%) meningeal, and other locations 18 (5.9); MF 38 cases (10.3%); DF 8 cases (2.1%) and miliary TB 1 cases (4.6%). In HIV infected patients 17 EF (77.3%), which were mainly ganglionary (64.7%); 4 DF (18.2%); and 1miliary TB (4.5%) cases were observed. Conclusions: Our findings confirm the high incidence of extrapulmo - nary TB, similar to the number of pulmonary forms. Our experience shows a significant modification to the classical presentation of the dise - ase, and thus the need for sensitivity in locating the disease.