Beyond the Chest: Extrapulmonary Tuberculosis

Congress:

ECR 2018

Poster Number:

C-2473

Type:

Educational Exhibit

Keywords:

Abdomen, Head and neck, Bones, CT, MR, Ultrasound, Sclerosis, Perception image, Treatment effects, AIDS, Tropical diseases, Infection

Authors:

Z. Wahab¹, A. Gangahar ¹, J. Zhong¹, H. Nejadhamzeeigilani¹, H. Bardgett², M. Kon²; ¹Leeds/UK, ²Bradford/UK

DOI:

10.1594/ecr2018/C-2473

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2473

Fig. 1: Axial CT images demonstrating mediastinal lymphadenopathy and a pericardial...

Fig. 2: MR imaging of a 32 year old female with prior mesenteric TB presenting with...

Fig. 3: MR imaging of a 33 year old male with a prior history of pulmonary and spinal...

Fig. 4: CT and MR images of a 25 year old patient with confusion, and left sided motor...

Learning objectives

Thispictorial review illustrates the radiological manifestations of extra-pulmonary tuberculosis. This will highlight key features that favour a diagnosis of tuberculosis (TB) over other pathologies and discuss extra-pulmonary TB complications.

Background

The worldwide incidence of TB is rising due to increased migration, a rising incidence of HIV, and an increase in multi-drug resistant strains. The main form of transmission of TB is airborne and thus involves inhalation into lung tissue. TB has historically been more prevalent in low socio-economic populations and also in overcrowded environments [1]. The incidence of reactivation ishigher in the immunocompromised, such as those with HIV; reports show this to be an estimate 16-27 times higher risk [1]. The ability of TB to...

Findings and procedure details

TB is most commonly limited to the chest, but recognition of the radiological findings of extra-pulmonary TB, which can often mimic other disease entities, is an important step in accurate diagnosis. We aim to illustrate the common imaging findings in a system based approach and will cover: Cardiac Central nervous system Head and neck Musculoskeletal Gastrointestinal/abdominal Genitourinary Cardiac Rare Via lymphatic spread Imaging findings on CT - pericardial effusion with irregular pericardial thickening (See Fig. 1 ) A history of pulmonary TB should raise suspicion...

Conclusion

Extrapulmonary TB can involve any system in the body as outlined and mimics other diseases. Diagnosis requires a high index of suspicion especially in high risk groups to instigate timely treatment and prevent significant complications.

Personal information

References

[1] GLOBAL TUBERCULOSIS REPORT 2017. World Health Organisation. [2] P. Kumar and M Clark, Kumar and Clark Clinical Medicine, 5th edition. 2002 [3] Grainger. Grainger and Allison’s Diagnostic Radiology, 6th edition. 2015 [4] Burrill J, Williams CJ, Bain G, Conder G, Hine AL, Misra RR. Tuberculosis: a radiologic review. Radiographics. 2007 Sep-Oct;27(5):1255-73. [5] Muttarak M, Peh WC, Lojanapiwat B, Chaiwun B (2001) Tuberculous epididymitis and epididymo-orchitis: sonographic appearances. AJR Am J Roentgenol 176: 1459-1466.