Evaluation of following and treatment results iin extrapulmonary tuberculosis cases who diagnosed with culture

Background and aim: Tuberculosis (TB) is a disease which can pleace on every organ especially the lungs occuring, caused by Mycobacterium tuberculosis. In recent years, especially in the developed countries, incidance of TB has increased due to the increase in the people with acquired immundeficiency that HIV, leukemia, diabetes, alcohol and drug addiction or congenital syndromes cause. In our study, we aimed to investigate the distrubition of the cases with extrapulmonary tuberculosis (ETB) diagnosed by the culture annually, clinical forms, demografic datas, clinical laboratory and treatment results in our hospitals between 2004 and 2010 retrospectively.Materials and methods: The cases were selected according to the ETB species in which grows M. tuberculosis in Inonu University Medical Faculty, Department of Microbiology and Clinic Microbiology, Moleculer Microbiology Laboratory between 2004 to 2010. The demografic, clinical and laboratory datas were recorded on the patient form. Student?s t test, Mann-Withney U test, Pearson Chi Square test or Fisher?s exact test were used for the comparison of the patients? findings. The ones with p< 0.05 were accepted as statistically significant.Results: The study included 73 patients, 23 (31.5%) were male and 50 (68%) were female. The mean age was 46.4±18.2 and age interval was 17-83 years. Of the patients ETB diagnosed 23 (31.5%) were TB lymphadenitis, 16 (%21.9) were musculoskeletal TB, 11 (15%) were disseminated TB, 6 (8.2%) were urinary TB, 5 (6.8%) were TB meningitis, 4 (5.5%) were genital TB, 4 (5.5%) were abdominal TB, 3 (4.1%) were skin TB, 1 (1.4 %) was pleural TB.M. tuberculosis grew in the lymph node species (35.6%) at most, the lymph node that grew at most was the servical lylymph nodes (65.4%). In the species that was observed in microbiology laboratory, the ratio of ARB positiveness was 17.5%, whereas ARB positiveness in the histopathologic species was 50%. There was granulomatous changes in all the species which were histopathologically evaluated and there was necrosis in 77.8%. The sensitivity of anti-TB drugs was stutied in 55 (75.3%) patients and in the 11 (20%) of the patients there was a resistance against at least one anti-TB drug. The resistance of INH, SM, EMB, RIF was detected in 8 (14.5%), 5 (9.1%), 2 (3.7%), 1 (1.8%) case, respectively. One patient of 43 patients who went on with CNS TB died due to the complications that developed after reccurence. The number of the patients who produced M. tuberculosis in the culture after death was 4 and composed 44.4% of the deads. The number of the patients who died whose treatments were completed or the treatment continued or the treatment couldn?t be started was 9 (16.1%) of 56.Conclusions: ETB is diagnosed mostly by clinical, histopathological, radiological and lesser microscopy and culture positiveness. However, because of the difficulties in microbiologic diagnosis, especially the delay in the treatmentof severe disease, the mortality risk increases. So that in the countries were TB is seen often like our country, ETB should be mentioned and it is important that to starts anti-TB treatment after taking appropriate clinical specimens in the patients that support clinical descriptions.