Patterns of Organ Involvement and Mortality in Extrapulmonary Tuberculosis: A Twelve-Year Retrospective Study

Halime Araz; Saliha Kazcı; Fatma Eser; Adalet Aypak

Article Details

Patterns of Organ Involvement and Mortality in Extrapulmonary Tuberculosis: A Twelve-Year Retrospective Study

Authors:

Halime Araz | Saliha Kazcı | Fatma Eser | Adalet Aypak

Publisher:

Ankara University

Main Topics:

Infectious Diseases

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.227-238

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358152

pISSN:

0365-8104

Keywords:

Abstract:

 Objective: Extrapulmonary tuberculosis EPTB accounts for a growing proportion of the global TB burden, with rising incidence in many countries, including Türkiye. This study aimed to describe the demographic, clinical, diagnostic, and therapeutic characteristics of adult patients diagnosed with EPTB in a tertiary care setting. Methods: This retrospective cohort included adults 18 years diagnosed with EPTB between June 2010 and March 2022 at two tertiary hospitals in Ankara. Descriptive and comparative statistical analyses were performed. Results: A total of 93 patients were included 51.6 male; median age: 55 years. The most affected sites were spinejoints 32.3, lymph nodes 26.9, and the central nervous system 16.1. Histopathological confirmation was achieved in 60.2, culture positivity in 30.1, and PCR positivity in 31.2. AFB staining was positive in 25.8, and drug susceptibility testing was performed in 27.9, revealing resistance in two patients. Standard four-drug anti-TB therapy was initiated in 95.7 of cases, with a median duration of 6 months range: 113. Surgery was required in 22.6 of patients. Nine patients 9.7 died during follow-up. Immunosuppression was significantly more common among non-survivors 44.4 vs. 11.9, p  0.027, who also had shorter durations of therapy p  0.001. Conclusion: EPTB in adults can present with severe forms, particularly spinal and CNS involvement. Histopathology remains a key diagnostic tool. Mortality was associated with immunosuppression and insufficient treatment duration, highlighting the need for early diagnosis and individualized management strategies.

 Objective: Extrapulmonary tuberculosis EPTB accounts for a growing proportion of the global TB burden, with rising incidence in many countries, including Türkiye. This study aimed to describe the demographic, clinical, diagnostic, and therapeutic characteristics of adult patients diagnosed with EPTB in a tertiary care setting. Methods: This retrospective cohort included adults 18 years diagnosed with EPTB between June 2010 and March 2022 at two tertiary hospitals in Ankara. Descriptive and comparative statistical analyses were performed. Results: A total of 93 patients were included 51.6 male; median age: 55 years. The most affected sites were spinejoints 32.3, lymph nodes 26.9, and the central nervous system 16.1. Histopathological confirmation was achieved in 60.2, culture positivity in 30.1, and PCR positivity in 31.2. AFB staining was positive in 25.8, and drug susceptibility testing was performed in 27.9, revealing resistance in two patients. Standard four-drug anti-TB therapy was initiated in 95.7 of cases, with a median duration of 6 months range: 113. Surgery was required in 22.6 of patients. Nine patients 9.7 died during follow-up. Immunosuppression was significantly more common among non-survivors 44.4 vs. 11.9, p  0.027, who also had shorter durations of therapy p  0.001. Conclusion: EPTB in adults can present with severe forms, particularly spinal and CNS involvement. Histopathology remains a key diagnostic tool. Mortality was associated with immunosuppression and insufficient treatment duration, highlighting the need for early diagnosis and individualized management strategies.

 Objective: Extrapulmonary tuberculosis EPTB accounts for a growing proportion of the global TB burden, with rising incidence in many countries, including Türkiye. This study aimed to describe the demographic, clinical, diagnostic, and therapeutic characteristics of adult patients diagnosed with EPTB in a tertiary care setting. Methods: This retrospective cohort included adults 18 years diagnosed with EPTB between June 2010 and March 2022 at two tertiary hospitals in Ankara. Descriptive and comparative statistical analyses were performed. Results: A total of 93 patients were included 51.6 male; median age: 55 years. The most affected sites were spinejoints 32.3, lymph nodes 26.9, and the central nervous system 16.1. Histopathological confirmation was achieved in 60.2, culture positivity in 30.1, and PCR positivity in 31.2. AFB staining was positive in 25.8, and drug susceptibility testing was performed in 27.9, revealing resistance in two patients. Standard four-drug anti-TB therapy was initiated in 95.7 of cases, with a median duration of 6 months range: 113. Surgery was required in 22.6 of patients. Nine patients 9.7 died during follow-up. Immunosuppression was significantly more common among non-survivors 44.4 vs. 11.9, p  0.027, who also had shorter durations of therapy p  0.001. Conclusion: EPTB in adults can present with severe forms, particularly spinal and CNS involvement. Histopathology remains a key diagnostic tool. Mortality was associated with immunosuppression and insufficient treatment duration, highlighting the need for early diagnosis and individualized management strategies.

 Amaç: Ekstrapulmoner tüberküloz EPTB, küresel tüberküloz yükünün artan bir kısmını oluşturmaktadır ve Türkiye dâhil birçok ülkede insidansı yükselmektedir. Bu çalışmada, üçüncü basamak bir sağlık kuruluşunda EPTB tanısı alan erişkin hastaların demografik, klinik, tanısal ve tedaviye ilişkin özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu retrospektif kohort çalışmaya, Haziran 2010  Mart 2022 tarihleri arasında Ankaradaki iki üçüncü basamak hastanede EPTB tanısı alan 18 yaş ve üzeri erişkin hastalar dâhil edilmiştir. Tanımlayıcı ve karşılaştırmalı istatistiksel analizler yapılmıştır. Bulgular: Toplam 93 hasta dâhil edilmiştir 51,6 erkek; medyan yaş: 55 yıl. En sık tutulan bölgeler omurgaeklemler 32,3, lenf nodları 26,9 ve merkezi sinir sistemi 16,1 idi. Histopatolojik doğrulama 60,2, kültür pozitifliği 30,1, PCR pozitifliği 31,2 oranında sağlandı. AFB boyası 25,8 pozitifti. İlaç duyarlılık testi 27,9 hastada yapılmış ve iki olguda direnç saptanmıştır. Hastaların 95,7sine standart dörtlü anti-TB tedavisi uygulanmış, medyan tedavi süresi 6 ay 113 ay idi. 22,6 hastada cerrahi müdahale gerekmiştir. Takipte 9 hasta 9,7 hayatını kaybetti. Bağışıklık baskılanması ölenlerde anlamlı düzeyde daha fazlaydı 44,4 vs. 11,9, p  0,027 ve bu hastalarda tedavi süresi daha kısaydı p  0,001. Sonuç: EPTB erişkinlerde ciddi tablolarla seyredebilir. Vertebra ve merkezi sinir sistemi tutulumu sık olup, tanıda histopatoloji belirleyicidir. Bağışıklık baskılanması ve yetersiz tedavi süresi mortaliteyle ilişkilidir. Erken tanı ve bireyselleştirilmiş tedavi yaklaşımları önem taşımaktadır.

Article Details

Patterns of Organ Involvement and Mortality in Extrapulmonary Tuberculosis: A Twelve-Year Retrospective Study

Authors:

Halime Araz | Saliha Kazcı | Fatma Eser | Adalet Aypak

Publisher:

Ankara University

Main Topics:

Infectious Diseases

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.227-238

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358152

pISSN:

0365-8104

Extrapulmonary tuberculosis

spinal TB

TB meningitis

mortality

histopathologyEkstrapulmoner tüberküloz

TB menenjiti

mortalite

histopatoloji

spinal TB

Issues

Article Details

Authors: Halime Araz | Saliha Kazcı | Fatma Eser | Adalet Aypak

Publisher: Ankara University

Main Topics: Infectious Diseases

Journal: Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.227-238

Document Type: Article

Publication Date: 9/2025

Document Language: English

Document ID (Org No.): 2001358152

pISSN: 0365-8104

Issues

Authors:

Halime Araz | Saliha Kazcı | Fatma Eser | Adalet Aypak

Publisher:

Ankara University

Main Topics:

Infectious Diseases

Journal:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 3, pp.227-238

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001358152

pISSN:

0365-8104