Do You Know What Extrapulmonary Tuberculosis is ?

Friends of Hermina, besides the tuberculosis that we often encounter, there is also what is called "extrapulmonary TB." Extrapulmonary TB has the same cause as pulmonary tuberculosis, namely Mycobacterium tuberculosis. This bacterium is rod-shaped and acid-resistant, which is why it is also called Acid Resistant Rod (BTA).

The source of transmission is a positive TB patient who coughs or sneezes. Infected people spread the bacteria into the air in the form of droplets (sputum spurts) so that they can develop into pulmonary tuberculosis, and within a few years, pulmonary tuberculosis can spread to other organs through hematogenous or lymphogenous routes or through blood transfusions. Extrapulmonary tuberculosis can usually infect organs outside the lungs, such as lymph nodes, meninges, joints, kidneys, bones, skin, and even the genitals. The signs and symptoms of extrapulmonary tuberculosis usually vary depending on the part of the body affected. However, the main feature that usually presents itself is a gradual decline in physical condition.

 

Types of extrapulmonary tuberculosis

1. Miliary TB

This spread is usually hematogenous or bloodborne. The disease tends to be more common in patients with HIV, chronic kidney disease, patients who have undergone organ transplantation, and patients who are receiving anti-TNF therapy for rheumatoid arthritis. Military tuberculosis usually attacks organs such as the liver, spleen, lymph nodes, lining of the brain, adrenal glands, and spinal cord.

2. Tuberculosis of the lymph nodes

People living with HIV/AIDS and children are at the greatest risk of developing glandular tuberculosis. This condition is usually marked by swollen lymph nodes in one or several parts of the body.

3. Tuberculosis of bones and joints Tuberculosis of the bones and joints is common in children. This is probably due to the condition of the child's bones and joints, which are still in their infancy. There are three types of bone and joint tuberculosis that are most common, that is :

• The joints most commonly affected are the hips, knees, elbows, and wrists.
• Osteitis is an inflammation that usually occurs in long bones, such as the legs. Sometimes this condition is caused by untreated arthritis that is not treated immediately.
• Spondylodiscitis is an extrapulmonary tuberculosis that occurs in the spine and can cause damage and disability to the spine.

4. Gastrointestinal tuberculosis

Tuberculosis bacteria can also enter the digestive tract, usually as a result of an active pulmonary tuberculosis infection, which occurs when a patient with M. tuberculosis swallows fluids contaminated with it. Symptoms of this condition are quite difficult to distinguish from other health conditions, namely:

• stomach ache
• Flatulence
• Fatigue
• Fever
• sweating at night
• weight loss
• Diarrhea
• Constipation
• blood in the stool.

The most common complication resulting from improper treatment of gastrointestinal tuberculosis is intestinal obstruction, also known as intestinal tuberculosis.

5. Tuberculosis meningitis

Meningitis caused by tuberculosis is more common in infants under 2 years of age and adults with HIV/AIDS. Some common signs and symptoms are: 

• Headache
• easy anger
• Fever
• Confusion
• stiff neck
• muscle weakness in infants
• photosensitivity (light sensitivity)
• nausea and vomiting.

6. Tuberculous pericarditis

Tuberculous pericarditis usually occurs after other organs are infected with tuberculosis bacteria. Therefore, this condition is often associated with miliary tuberculosis. If left untreated, TB pericarditis can lead to heart complications such as constrictive pericarditis and cardiac tamponade.

 

7. Tuberculosis of the genital and urinary tract

Extrapulmonary tuberculosis can also occur in the genital and urinary tracts, often called urogenital tuberculosis. Some common signs and symptoms are: 

• stomach ache
• pain during urination
• urinating more often than usual, especially at night (nocturia)
• back and rib pain
• swelling of the testes
• there are red blood cells in the urine
• tuberculous pleural effusion.

8. Tuberculosis of the skin A bacterial tuberculosis infection can also attack skin tissue and cause skin tuberculosis. Extrapulmonary TB has symptoms in the form of lesions that form blisters and cause the skin to swell. These symptoms usually appear on the knees, elbows, hands, neck, and feet 2–4 weeks after the bacteria infect the skin tissue. The severity of symptoms can vary from person to person depending on the state of the immune system. Other symptoms of extrapulmonary tuberculosis involving the skin include:

• a purple-brown rash around skin lesions
• pain on broken skin
• erythema, or a red rash that spreads over the skin
• and skin damage that persists for years.

 

On the other hand, like pulmonary tuberculosis, extrapulmonary tuberculosis can also be cured. The treatment is not much different from that for pulmonary tuberculosis, namely, oral anti-tuberculosis (OAT), although adjustments must be made for several diseases that infect vital organs. If Hermina's friend experiences any of the above symptoms, immediately contact a pulmonary specialist at Hermina Hospital.