Epidemiology and Clinical Management of Extrapulmonary Tuberculosis
Summary
Extrapulmonary tuberculosis (EPTB) encompasses disease caused by Mycobacterium tuberculosis complex at sites beyond the pulmonary parenchyma, accounting for approximately 15–25% of all tuberculosis cases globally. Its clinical manifestations vary widely according to the anatomical site involved, most commonly lymphatic, pleural, skeletal and meningeal compartments, and may present with non‐specific constitutional symptoms. The epidemiology of EPTB is shaped by host factors such as age, sex, immune status (notably HIV infection), and geographic or socioeconomic background, as well as pathogen factors including bacterial lineage. Incidence rates differ between regions, with higher burdens reported in areas of endemic disease and among vulnerable populations. Diagnosis poses a challenge owing to the often insidious onset and the need for invasive sampling; it typically relies on a combination of imaging studies, microbiological culture or molecular assays, and histopathological confirmation. Clinical management follows standard anti-tuberculosis chemotherapy, although treatment duration and choice of regimen may be adapted according to site and severity of involvement. Drug susceptibility testing is essential to detect resistance, guide therapy and reduce the risk of treatment failure. Adjuvant corticosteroid therapy and, in some cases, surgical intervention are employed to manage complications such as spinal cord compression or loculated effusions. Ongoing research seeks to refine diagnostic algorithms, optimise therapeutic strategies and address emerging drug resistance in extrapulmonary settings.
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Epidemiology and Clinical Management of Extrapulmonary Tuberculosis publication trend
The graph below shows the total number of articles in epidemiology and clinical management of extrapulmonary tuberculosis across all publications each year (not limited to Nature Index journals).
Technical terms
Extrapulmonary tuberculosis: Tuberculosis infection affecting organs or tissues outside the lungs.
Drug susceptibility testing: Laboratory assessment of Mycobacterium sensitivity to anti-tuberculosis drugs.
Multidrug-resistant tuberculosis (MDR-TB): Strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin.
Tuberculous pleurisy: Inflammation of the pleural lining due to Mycobacterium tuberculosis infection.
Histopathology: Microscopic examination of tissue specimens to identify disease-related changes.
Spatiotemporal analysis: Evaluation of disease distribution over geographic space and time to detect patterns and trends.
References
- Pathogen and host determinants of extrapulmonary tuberculosis among 1035 patients in Frankfurt am Main, Germany, 2008–2023. Clinical Microbiology and Infection (2024).
- Trend of the Tuberculous Pleurisy Notification Rate in Eastern China During 2017-2021: Spatiotemporal Analysis. JMIR Public Health and Surveillance (2023).
- Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance. Journal of Respiration (2021).
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