Type:
Educational Exhibit
Keywords:
Infection, Abscess, Diagnostic procedure, Ultrasound, MR, CT, Lymph nodes, Head and neck, CNS
Authors:
L. Fatahi Bandpey1, D. yago1, F. O. Lenghel1, P. J. Sanchez Santos1, I. Fernandez Bedoya2, B. Fatahi Bandpey1; 1TERUEL/ES, 2Buenos Aires/AR
DOI:
10.1594/ecr2013/C-2396
Background
Tuberculosis (TB),
discovered in 1882 by Robert Koch,
is considered by some as the most common infectious-contagious disease in the world.
Although its incidence has been on the decline since 2002,
among the 8.8 million cases of tuberculosis reported worldwide in 2010,
an estimated 418 000 individuals were located in the European Region.
Undoubtedly the disease still remains a major threat despite control efforts and its resurgence in the mid 90´s has been mainly attributed to different causes,
such as increased global migrations,
Human Immunodeficiency Virus and the appearance of multidrug-resistant forms.
TB can involve any organ system in the whole body and it can be life-threatened.
While pulmonary TB is the most common presentation,
extrapulmonary tuberculosis (EPTB) is also an important clinical problem (it accounts for 10-20% of all cases of tuberculosis in immunocompetent patients,
and up to 60% in AIDS patients).
The term EPTB has been used to describe isolated occurrence of TB at body sites other than the lung.
However,
practically in all the cases of EPTB a primary pulmonary focus exists,
which can be visible or not in chest radiographs.
EPTB is the result of dissemination of tubercle bacilli from this initial focus in the lungs soon after primary infection.
The dissemination is mainly by contiguity,
or by way of the lymphatic or hematogenous route.
Excepting the pleural involvement,
the nodal,
urogenital and osteoarticular are the most frequent locations of EPTB.
Other localizations are highly infrequent.
Early detection is crucial to successful management and requires a high-clinical suspicion.
Imaging plays a key role in its diagnosis,
however the course of TB and its resultant radiological pattern fall out of the interaction between the organism (Mycobacterium tuberculosis) and the patient response.