Extrapulmonary Tuberculosis

Sep 16, 2019 admin NHIỄM KHUẨN 0

Extrapulmonary Tuberculosis

Aka: Extrapulmonary Tuberculosis, Disseminated tuberculosis, Miliary Tuberculosis

II. Distribution: Areas of dissemination

  1. Tuberculous Lymphadenitis (most common form)
  2. Pleural Tuberculosis (5%)
  3. Skeletal Tuberculosis (35%)
  4. Tuberculous Meningitis
    1. CSF with moderate lymphcytosis
  5. Gastrointestinal Tuberculosis
  6. Genitourinary Tuberculosis
  7. Tuberculous Peritonitis
  8. Miliary Tuberculosis
  9. Tuberculous Pericarditis
  10. Miliary Tuberculosis (Disseminated tuberculosis)
    1. Seen in AIDS and untreated Tuberculosis
    2. Presents with fever, Night Sweats, weight loss
    3. PPD is positive in only 50% of cases

III. Management

  1. Duration of therapy (phase 1 and 2 combined)
    1. Most forms of Extrapulmonary Tuberculosis: 4-7 months
    2. CNS Tuberculosis: 9-12 months
    3. Musculoskeletal Tuberculosis: Extended duration
  2. Phase 1: First 2 months (altered if suspect resistance)
    1. Isoniazid
    2. Rifampin
    3. Pyrazinamide
    4. Ethambutol
  3. Phase 2: Duration varies per guidelines above
    1. Isoniazid
    2. Rifampin

IV. References

  1. Golden (2005) Am Fam Physician 72(9):1761-8 [PubMed]

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