Department of Pulmonary Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, 110029, India; Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Department of Transplant Immunology and Immunogenetics, All India Institute of Medical Sciences, New Delhi, 110029, India.
Respir Med. 2024 Apr-May;225:107601. doi: 10.1016/j.rmed.2024.107601. Epub 2024 Mar 19.
Tuberculosis (TB) remains a major global public health problem worldwide. Though Pulmonary TB (PTB) is mostly discussed, one in five cases of TB present are extrapulmonary TB (EPTB) that manifests conspicuous diagnostic and management challenges with respect to the site of infection. The diagnosis of EPTB is often delayed or even missed due to insidious clinical presentation, pauci-bacillary nature of the disease, and lack of laboratory facilities in the resource limited settings. Culture, the classical gold standard for the diagnosis of tuberculosis, suffers from increased technical and logistical constraints in EPTB cases. Other than culture, several other tests are available but their feasibility and effciacy for the detection of EPTB is still the matter of interest. We need more specific and precise test/s for the various forms of EPTB diagnosis which can easily be applied in the routine TB control program is required. A test that can contribute remarkably towards improving EPTB case detection reducing the morbidity and mortality is the utmost requirement. In this review we described the scenario of molecular and other noval methods available for laboratory diagnosis of EPTB, and also discussed the challenges linked with each diagnostic method. This review will make the readers aware of new emerging diagnostic techniques in the field of EPTB diagnosis. They can make an informed decision to choose the appropriate one according to the test availability, their clinical settings and financial considerations.
结核病（TB）仍然是全球范围内的一个主要公共卫生问题。虽然主要讨论的是肺结核（PTB），但每五个结核病病例中就有一个是肺外结核病（EPTB），这种疾病在感染部位表现出明显的诊断和管理挑战。由于隐匿的临床表现、疾病的少菌性以及资源有限环境下缺乏实验室设施，EPTB 的诊断常常被延迟甚至被遗漏。培养是结核病诊断的经典金标准，但在 EPTB 病例中，它受到技术和后勤方面的限制。除了培养之外，还有其他几种检测方法可用，但它们在检测 EPTB 方面的可行性和效果仍然是人们关注的问题。我们需要针对各种形式的 EPTB 诊断的更具体和更精确的检测方法，这些方法可以很容易地应用于常规的结核病控制项目中。需要有一种能够显著提高 EPTB 病例检出率、降低发病率和死亡率的检测方法。在这篇综述中，我们描述了用于 EPTB 实验室诊断的分子和其他新方法的情况，并讨论了每种诊断方法所涉及的挑战。这篇综述将使读者了解 EPTB 诊断领域的新兴诊断技术。他们可以根据测试的可用性、临床环境和经济考虑因素，做出明智的决策，选择合适的方法。
