ISSN: 2547-9431
Periodical Publication of University of Health Sciences Bagcilar Training and Research Hospital
Evaluation of extrapulmonary tuberculosis cases presenting with different clinical findings
Abdulrahman Ozel, Meltem Erol, Ozlem Bostan Gayret, Can Polat, Ozgul Yigit, Fatih Mete
Bagcilar Medical Bulletin 2018;3(4):65-72
Introduction: Extrapulmonary tuberculosis cases may display different clinical symptoms and this causes a delay in diagnosis. Nutritional deficiencies, migrations, and wars facilitate the development and the spreading speed of the disease. The aim of this article is to examine extrapulmonary tuberculosis patients with different clinical presentations.

Method: In this study, 15 extrapulmoner tuberculosis cases who were hospitalized and treated in our pediatrics clinic in the last two years, has been evaluated retrospectively.

Results: The average age of our group was 11.7 ± 4.5 and six of the assessed patients were Syrian origin. The shared complaints of five patients diagnosed with peritoneal tuberculosis were abdominal pain and bloating. Abdominal ultrasonography findings of the patients in concordance with diffuse ascites. Two of these patients, Mycobacterium tuberculosis had peritoneal effusion. All of the five patients diagnosed with lymph node tuberculosis had swelling on the neck, and all had pulmonary involvement. However, only one patient's lymph node biopsy was concordant with tuberculosis. One patient bone tuberculosis patient applied to our clinic with hip and back pain symptom. Pott’s abscess was observed in the patient's thorax MRI and hip MRI was concordant with tuberculous arthritis. Our patient with renal tuberculosis was diagnosed during evaluation of sterile pyuria attacks and in her urine ARB (+) was detected and M. tuberculosis grew in urine culture. One patient with central nervous system involvement applied to our clinic with clouding of consciousness and headache. The cerebrospinal fluid (CSF) findings of the patient were concordant with tuberculosis and growth was observed in the CSF culture. One case with miliary tuberculosis had hypercalcemia and pulmonary involvement. The patient's M. tuberculosis DNA PCR test was positive in bronchoalveolar lavage fluid. Another patient with pericardial tuberculosis applied due to respiratory distress and had cardiomegaly and pericardial effusion. Nine of our patients also had a contact history, 12 had purified protein derivative of tuberculin (PPD) (+), and 11 had pulmonary involvement.

Conclusion: Patients were admitted to our outpatient clinic with various clinical symptoms. After careful physical examinations were performed, detailed patient histories were taken and laboratory tests performed for differentials, patients were diagnosed with extrapulmonary tuberculosis. It was desired to emphasize that this disease may appear with different clinical presentations in endemic regions like our country.

Keywords: Child, extrapulmonary tuberculosis, pulmonary tuberculosis

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