HomeInternationally, pulmonary TB is defined as disease involving the lung parenchyma or tracheobronchial tree. Extra-pulmonary TB (EPTB) is defined as disease involving any other organs and includes pleural and isolated intrathoracic lymph node TB.1 This differs from the terminology for reporting in Canada, which classifies TB as either respiratory (lungs and the conducting airways, pleural, fibrosis of the lung, bronchiectasis, pneumonia, pneumothorax, primary, intrathoracic and mediastinal lymph nodes, isolated tracheal or bronchial, laryngitis, nasopharynx, nose and sinus TB) or nonrespiratory (all other disease sites not listed).2 This chapter focuses on the diagnosis and treatment of EPTB.
Over the last 10 years in Canada, the incidence of EPTB has remained stable, similar to other low TB-incidence, and low HIV-TB co-infection countries.3 Peripheral TB lymphadenitis, pleural TB and abdominal TB have remained the three most common types of EPTB (see Chapter 1: Epidemiology of Tuberculosis in Canada). Impaired host immune status is a risk factor for EPTB and increases associated mortality. Organ transplant recipients, persons with advanced HIV and those undergoing chemotherapy for malignancies are at particularly high risk of life-threatening disease.4–9
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