Norbis Luca, Alagna Riccardo, Tortoli Enrico, Codecasa Luigi Ruffo, Migliori Giovanni Battista, Cirillo Daniela M
San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milano, Italy.
Expert Rev Anti Infect Ther. 2014 May;12(5):633-47. doi: 10.1586/14787210.2014.899900. Epub 2014 Mar 20.
Extrapulmonary tuberculosis (EPTB) accounts for a significant proportion of tuberculosis cases worldwide. Nevertheless, the diagnosis is often delayed or even missed due to insidious clinical presentation and poor performance of diagnostic tests. Culture, the classical gold standard for tuberculosis, suffers from increased technical and logistical constraints in EPTB cases. In this review the authors outline current diagnostic options for the main forms of EPTB. The authors also discuss the opportunities and challenges linked in particular to microbiological diagnostics and to the attempts to find a new gold standard test for EPTB. Finally, new biomarkers and tests currently under evaluation are hopefully on the way to introduce significant improvements in EPTB diagnosis, for which clinical suspicion will nevertheless be essential.
肺外结核病（EPTB）在全球结核病病例中占相当大的比例。然而，由于临床表现隐匿且诊断测试效果不佳，诊断往往会延迟甚至漏诊。培养作为结核病的经典金标准，在EPTB病例中面临技术和后勤方面越来越多的限制。在这篇综述中，作者概述了EPTB主要形式的当前诊断选择。作者还讨论了特别是与微生物诊断以及寻找EPTB新金标准测试的尝试相关的机遇和挑战。最后，目前正在评估的新生物标志物和测试有望在EPTB诊断方面带来重大改进，不过临床怀疑仍然至关重要。
