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Clinical manifestations and diagnosis of extrapulmonary tuberculosis

 Hee Jung Yoon  ;  Young Goo Song  ;  June Myung Kim  ;  Kyung Hee Chang  ;  Jae Pil Choi  ;  Woo Il Park 
 YONSEI MEDICAL JOURNAL, Vol.45(3) : 453-461, 2004 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Biopsy ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Prevalence ; Radiography ; Retrospective Studies ; Tuberculosis/diagnostic imaging ; Tuberculosis/epidemiology* ; Tuberculosis/pathology* ; Tuberculosis, Lymph Node/diagnostic imaging ; Tuberculosis, Lymph Node/epidemiology ; Tuberculosis, Lymph Node/pathology ; Tuberculosis, Osteoarticular/diagnostic imaging ; Tuberculosis, Osteoarticular/epidemiology ; Tuberculosis, Osteoarticular/pathology ; Tuberculosis, Pleural/diagnostic imaging ; Tuberculosis, Pleural/epidemiology ; Tuberculosis, Pleural/pathology ; Tuberculosis, Pulmonary/diagnostic imaging ; Tuberculosis, Pulmonary/epidemiology ; Tuberculosis, Pulmonary/pathology
Tuberculosis ; extrapulmonary tuberculosis ; diagnosis
Since the diagnosis of extrapulmonary tuberculosis (EPT) is largely depended on the physician's suspicion in respect of the disease, we believed that it would be worthwhile to scrutinize the clinical characteristics of EPT. Thus, here we present retrospectively evaluated clinical manifestations of patients who were diagnosed as EPT cases in a tertiary referral care hospital.

Medical records of 312 patients, diagnosed as having EPT at Yongdong Severance hospital from January 1997 to December 1999, were reviewed retrospectively.

In total 312 patients, 149 (47.8%) males and 163 (52.2%) females aged from 13 years to 87 years, were included into this study. The most common site of the involvement was pleura (35.6%). The patients complained of localized symptoms (72.4%) more frequently than systemic symptoms (52.2%). The most common symptom was pain at the infected site (48.1%). Leukocytosis, anemia, and elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were found in 12.8%, 50.3%, 79.3% and 63.1% of the patients, respectively. Twenty-four percent of the patients had underlying medical illnesses such as, diabetes mellitus or liver cirrhosis, or were over 60 years old. In 67.3% of patients, tuberculosis was suspected at the initial visit. However, tuberculosis was microbiologically proven in only 23.7% of the patients. The time interval from the symptom onset to the diagnosis varied, with the mean duration of the period 96 days. Pulmonary parenchymal abnormal lesions were found in 133 patients (42.6%) on chest radiographs.

EPT has a wide spectrum of clinical manifestations, so it is difficult to diagnose it. Based on our studies, only 11.2% of the patients were confirmed as EPT. So it is important that the physician who first examines the patient should have a high degree of suspicion based on the chest radiography, localized or systemic symptoms and several laboratory parameters reviewed in this study.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Park, Woo Il(박우일)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Yoon, Hee Jung(윤희정)
Chang, Kyung Hee(장경희)
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