HomeThe pathogenesis of extrapulmonary TB has been attributed to lympho-hematogenous spread at the time of initial primary lung infection, later dissemination from reactivated pulmonary TB or contiguous spread from adjacent organs. Abdominal disease may also result from direct infection through ingestion of infected sputum or contaminated milk (M. bovis). Extrapulmonary TB or combined pulmonary and extrapulmonary TB is more common in those who are severely immunocompromised. Among people coinfected with HIV and TB, the prevalence of extrapulmonary TB increases as the CD4 count decreases (see Chapter 7: Extra-pulmonary Tuberculosis).66,67
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