Abstract
Background: Molecular epidemiological studies using genotyping proved that disease transmission is higher in EPTB which also proves the infectiousness of EPTB.
Aims and objectives: To detect the pulmonary involvement in new EPTB patients with the help of sputum examination, X-ray chest, High Resolution Computed Tomography scan of Thorax (HRCT) and Fiberoptic Bronchoscopy (FOB).
Methods: A total of 140 patients of EPTB referred to our DOTs center were investigated for pulmonary involvement from July 2009 through November 2010.
Results: The most common EPTB site was the Lymph nodes 46.43%, followed by pleural effusion 40.71%. Sputum could be collected from 87.14% patients, and showed 9.83% positivity for AFB on Direct smear and 11.47% positivity on culture. X-Ray chest was done in all 140 patients and parenchymal lesions detected in 82.85%. CT-Thorax could be done in 60.71% patients, and 88.23% showed parenchymal lesions. In FOB performed on 33 patients, 84.84% were found bacteriologically positive. Sputum culture had an additional yield of 2 over sputum smear. CT scan had an additional yield of 13 over x -ray. FOB had an additional yield of 26 over sputum examinations and 5 over x ray. Total patients with pulmonary involvement of 130 (92.85%) was found; of this bacteriologycally proven was 40 (28.57%) patients.
Conclusion: We observed that majority of extra pulmonary tuberculosis patients showed parenchymal involvement, significant bacillary positivity sometimes even with a normal chest x-ray. It suggests the potential infectiousness of extra pulmonary tuberculosis patients which is always under estimated, so contact investigations and the disease prevention precaution measures should also be advised in these patients.
- © 2011 ERS
