Learning objectives
Tuberculosis (TB) is a disease that can affect most organs and systems within the body.
Whilst we are generally comfortable with the usual presentation of pulmonary TB,
on many occasions TB presents itself in extra-pulmonary sites.
Not only can this result in unusual and unfamiliar presentation of TB,
but can often mimic other disease entities such as malignancy,
inflammatory disorders and other infections.
Through this article we will aim to:
Illustrate multiple sites of extra-pulmonary presentations of TB
Discuss the range of imaging appearances of...
Background
TB is second only to HIV and AIDs as the greatest killer worldwide by a single infective agent.
A combination of improvements in public health and development of antibiotics,
led to a fall in deaths from TB in Europe in the second half of the twentieth century.
However,
due to the emergence of HIV,
drug resistance and the increasing ease and availability of travel,
TB has become increasingly prevalent.
Although pulmonary TB is the most common site of disease,
27-49% of TB can occur outside...
Imaging findings OR Procedure details
Central nervous system (CNS) TB
CNS TB can affect the meninges,
brain or spinal cord.
This usually occurs secondary to haematogenous spread,
which can cause meningitis,
tuberculomas,
abscesses,
cerebritis or miliary TB.
TB Meningitis
Imaging findings suggestive of TB meningitis include homogenous meningeal enhancement,
which occurs usually in the basal cisterns and can extend into the interhemispheric fissures and around the spinal cord (Fig.
2).
TB meningitis can result in hydrocephalus and infarcts in a middle cerebral artery distribution due to arteritis of the vessels...
Conclusion
Although pulmonary TB is the most common and recognizable presentation of TB,
up to 47% of TB can present in extra-pulmonary sites.
The imaging findings of which can often mimic other disease entities such as inflammation,
other infections and malignancy.
Being able to recognize the distinguishing and suggestive features of TB will lead the clinician to perform the necessary subsequent investigations in order to provide a timely and correct diagnosis.
References
1.
W-K Lee,
F Van Tonder,
C Tartaglia,
C Dagia,
R Cazzato,
V Duddalwar,
S Chang.
CT appearances of abdominal tuberculosis.
Clinical Radiology (2012) 67: 596-604.
2.
Gulgun Engin,
Bulent Acunas,
Gulden Acunas,
Mehtap Tunaci.
Imaging of extrapulmonary tuberculosis.
RadioGraphics (2000) 20:471-488.
3.
Mukesh Harisinghani,
Theresa McLoud,
Jo-Anne Shepard,
Jane Ko,
Manohar Shroff,
Peter Mueller.
Tuberculosis from head to toe.
RadioGraphics (2000) 20:449-470.
4.
Sung Hwan Hong,
Sung Moon Kim,
Joong Mo Ahn,
Hye Won Chung,
Myung Jin Shin,
Heung Sik Kang.
Tuberculosis versus pyogenic...