REVIEW   

Minerva Pneumologica 2017 June;56(2):107-21

DOI: 10.23736/S0026-4954.17.01789-8

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

The role of surgery in extrapulmonary Mycobacterium tuberculosis infection

Donald E. FRY ^{1, 2, 3} ✉

¹ Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; ² School of Medicine, University of New Mexico, Albuquerque, NM, USA; ³ MPA Healthcare Solutions, Inc., Chicago, IL, USA

Tuberculosis continues to be a major infectious disease. While uncommon in developed countries, it is quite common in developing areas and may be associated with extrapulmonary disease in up to 15% of cases. Anti-tuberculosis chemotherapy is the treatment, but surgeons are consulted for the diagnosis and management of extrapulmonary disease. The reported medical literature on tuberculosis has been reviewed to identify the extrapulmonary manifestations of this disseminated disease and the potential roles of surgeons in the diagnosis and management. Extrapulmonary tuberculosis can be identified in virtually every organ space and in every tissue of the body, and is associated with immunosuppression (e.g., HIV infection) and failed treatment of the initial pulmonary infection. The diagnosis may masquerade as those diseases that are more common to the anatomic site, and local complications from mass-effect and tissue inflammation may require surgical intervention. Awareness of the true diagnosis of tuberculosis in these cases may temper judgment in management. The correct diagnosis should also be identified for the prevention of potential occupational risks of transmission. Extrapulmonary tuberculosis infection can be identified in any anatomic location. In an era of rapid transportation of people throughout the world, surgeons should be aware of the manifestations of disseminated disease.

KEY WORDS: Tuberculosis - Mycobacterium infections - Tuberculous peritonitis - Central nervous system tuberculosis