Merlo PM, Luévanos VA, Murillo NMV, Mercado UMC, Martínez APA, Guerrero BM, Plasencia HA, Aquino VD, Ornelas GK, Orozco AI, Reyes GU, Reyes HKL, Montaño AA

Language: Spanish
References: 11
Page: 17-20
PDF size: 293.27 Kb.

ABSTRACT

Introduction. Tuberculosis (TB) is the thirteenth leading cause of death worldwide. Since 2007 it had been the leading cause of death as a single infectious agent, it occurs predominantly in the lungs, but this pathology can also affect to other organs of the human body, representing between 15-25% of the total cases of tuberculosis in immunocompetent patients, and, in those individuals with aids or with severe immunocompromise, it can increase up to 50-70%. We report our casuistry of extrapulmonary tuberculosis of the Civil Hospital of Guadalajara during the period 2015-2018.
Clinical cases. 26 cases are presented, five were miliary (1 HIV positive), three peritoneal, seven lymph nodes, four central nervous system (CNS): two tuberculomas, two meningitis; four bone, two skin and one nasopharyngeal. The male-female ratio was 2.5:1, with an average age at diagnosis of 6.8 years, the most frequent sign being fever (80%) followed by adenopathy (48%); the specific symptoms reported were abdominal pain in the peritoneal presentation (100%), headache (90%) in the CNS presentation, polypnea and chest pain (50 and 70% respectively) in the miliary presentation. 40% of the patients presented malnutrition. In relation to diagnostic methods: 68% resulted with positive PPD (purified protein derivative); 16% with positive culture and 100% confirmed by PCR (polymerase chain reaction) in peritoneal tuberculosis (three in abdominal fluid and one in lymph node) and meningitis (cerebrospinal fluid). A mortality of 12% and cure of 88% were registered.
Conclusion. Extrapulmonary tuberculosis corresponded to 80.7% of all tuberculosis cases reported during the study period, a figure that exceeds the world data and those reported in our country, which alerts us to make earlier primary diagnoses given data from clinical suspicion.

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