Volume: 13 Issue: 1
Year: 2025, Page: 63-66, Doi: https://doi.org/10.47799/pimr.1301.12
Received: Feb. 13, 2025 Accepted: April 4, 2025 Published: April 7, 2025
Background: Extrapulmonary tuberculosis (EPTB) poses significant diagnostic challenges due to its diverse and often atypical clinical presentations. Case details: This case series from a tertiary care hospital in Pune, India, highlights five distinct EPTB presentations diagnosed between December 2022 and May 2024. The cases include recurrent suprasternal abscess with subsequent cervical lymphadenitis, pulmonary TB extending to cervical lymph nodes, subcutaneous thigh TB, pediatric tibial osteomyelitis, and disseminated mediastinal and cervical lymphadenitis. Diagnostic confirmation relied on ultrasonography, computed tomography (CT), histopathology, Ziehl-Neelsen staining, and cartridge-based nucleic acid amplification testing (CBNAAT), often detecting Mycobacterium tuberculosis (MTB) despite low bacterial loads. All cases received standard drug-sensitive TB (DS-TB) treatment, yielding varied outcomes, ranging from full recovery to recurrence in one instance. Conclusion: These cases underscore the need for heightened clinical suspicion in TB-endemic regions and emphasize the pivotal role of molecular diagnostics in recognizing atypical EPTB presentations. Early diagnosis and comprehensive follow-up are essential for optimizing patient outcomes.
Keywords: CBNAAT, Extra-pulmonary tuberculosis, Mycobacterium tuberculosis
Global tuberculosis report 2023. Geneva: World Health Organisation; Licence: CC BY-NC-SA 3.0 IGO. https://shorturl.at/2KIH2
Gopalaswamy, R, Dusthackeer, V N A, Kannayan, S & Subbian, S . 2021. Extrapulmonary Tuberculosis-An Update on the Diagnosis, Treatment and Drug Resistance. Journal of Respiration 1(2):141–164.
Kohli, M, Schiller, I, Dendukuri, N, Yao, M, Dheda, K, Denkinger, C M, Schumacher, S G & Steingart, K R . 2021. Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev. Cochrane Library: Cochrane reviews 15(1):CD012768.
Vidyaraj, C K, Vadakunnel, M J, Mani, B R, Anbazhagi, M, Pradhabane, G & Venkateswari, R . 2025. Prevalence of extrapulmonary tuberculosis and factors influencing successful treatment outcomes among notified cases in South India. Scientific Reports 15:1–12.
Agarwal, D, Suganita, , Yadav, V, Sachan, S, Goel, V & Jaiswal, H . 2024. Rare clinical forms and variants of cutaneous tuberculosis - a case series. International Journal of Life Sciences, Biotechnology and Pharma Research 13(5):195–201.
Rahangdale, A . 2022. Outcome of Bone Tuberculosis in Children in Rural India - A case series. Pediatric Oncall Journal 19(2):1–3.
Sreeramareddy, C T, Qin, Z Z, Satyanarayana, S, Subbaraman, R & Pai, M . 2014. Delays in diagnosis and treatment of pulmonary tuberculosis in India: a systematic review. International Journal of Tuberculosis and Lung Disease 18(3):255–266.
Manikanta, K V, Gowda, S, Harish, B R & Ariptha, V . 2022. Diagnostic delay and out of pocket expenditure in extrapulmonary tuberculosis patients: a cross-sectional study in DOTS centre of a tertiary care hospital in South India. International Journal Of Community Medicine And Public Health 9(4):1755–1759.
WHO operational handbook on Tuberculosis. Module 3, diagnosis- Rapid diagnosis for tuberculosis detection. 2021 update, Geneva WHO. https://www.who.int/publications/i/item/9789240030589
©2025 (Tejaswini Olambe) et al. This is an open-access journal, and articles are distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Olambe T, Shah P, Pol S, Belpatre A, Karyakarte R. Extrapulmonary Tuberculosis: A Case Series of Diagnostic Challenges and Unusual Presentations from a TerƟary Care Hospital in Pune. Perspectives in Medical Research. 2025;13(1):63-66 DOI: 10.47799/pimr.1301.12