Extrapulmonary tuberculosis

Abdominal infections include gastrointestinal tuberculosis (which is important to distinguish from Crohn's disease, since immunosuppressive therapy used for the latter can lead to dissemination), tuberculous peritonitis, and genitourinary tuberculosis. Miliary TB currently makes up about 10% of extrapulmonary cases. == Urogenital ==

Urogenital tuberculosis represents the second most frequent form of extrapulmonary tuberculosis, accounting for 30-40% of cases. Primarily affecting males in their fourth and fifth decades, decades after initial infection and pulmonary manifestations, the disease reactivates from bacteria colonizing the kidneys, prostate, and/or epididymis, with subsequent descending infection through the renal collecting system. The insidious progression typically produces symptoms only at advanced stages, and is frequently misdiagnosed as a common UTI, leading to diagnostic delay and organ destruction. Key clinical presentations include storage symptoms (frequency, nocturia, urgency) in 50.5% of cases, hematuria (35.6%), lumbar or flank pain (34.4%), and scrotal abnormalities (48.9% of males). Diagnosis requires culture or PCR detection of Mycobacterium tuberculosis in urine, supplemented by imaging studies showing characteristic findings such as calyceal irregularities, renal infundibular stenosis, and multiple ureteral strictures. If untreated, the condition can progress from unilateral renal involvement to fibrotic bladder damage with contraction, and potentially bilateral kidney involvement through vesicoureteral reflux, culminating in end-stage renal failure. ==Pleural effusion==

This condition is one of the common forms of extrapulmonary tuberculosis. It occurs during acute phases of the disease, with fever, cough, and pain while breathing (pleurisy). Pleural fluid usually contains mainly lymphocytes and the Mycobacterium bacteria. Gold standard of diagnosis is the detection of Mycobacterium in pleural fluid. Other diagnostic tests include the detection of adenosine deaminase (above 40 U/L) and interferon gamma in pleural fluid. ==References==