Extrapulmonary Tuberculosis: Challenges in Diagnosis and Treatment - Case series

Extrapulmonary tuberculosis (TB) accounts for 10%–15% of all the TB cases worldwide, as reported by WHO. Due to the diverse presentations of extrapulmonary TB, diagnosis is frequently challenging. This challenge is further compounded by the difficulty in obtaining adequate diagnostic samples and the low concentration of Koch’s bacilli. In this study, we discuss cases of patients aged between 32 years and 72 years with negative HIV serology, but with other risk factors that trigger extrapulmonary TB, including chronic inflammatory disease under treatment with monoclonal antibodies or corticosteroids, cancer, chronic obstructive pulmonary disease, or chronic kidney disease stage V. The patients had miliary, bone, and lymph node extrapulmonary TB, and their diagnostic methods, duration, and type of treatment varied based on their tolerance and response to treatment. In conclusion, our study highlights the challenges in diagnosing extrapulmonary TB, resulting from the diverse clinical presentations of the disease and difficulties in obtaining adequate diagnostic samples. Our findings provide potential solutions to these issues.