Stelianides S, Belmatoug N, Fantin B
Service de Médecine Interne, Hôpital Bichat-Claude Bernard, Paris.
Rev Mal Respir. 1997 Dec;14 Suppl 5:S72-87.
Extra pulmonary tuberculosis currently represents 25 per cent of notified tuberculosis in France. All organs can be involved but the most frequent localisation are the lymph nodes. Immunodepressed patients notably those infected with HIV are particularly prone to a polyvisceral tuberculous infection. The diagnosis is often difficult on account of the polymorphism of the disease and the weak specificity of the clinical manifestation. A firm diagnosis always rests on histological or microbiological evidence. Certain recent developments should enable a more rapid microbiological diagnosis notably as a result of development in molecular biology and rapid culture techniques. The mortality and morbidity remain elevated in developing counties as in industrialised counties and clinical situations in which extra pulmonary tuberculosis occur often worsen the prognosis.
目前,肺外结核病占法国通报结核病病例的25%。所有器官均可受累,但最常见的部位是淋巴结。免疫功能低下的患者,尤其是感染艾滋病毒的患者,特别容易发生多脏器结核感染。由于该疾病的多态性以及临床表现特异性不强,诊断往往很困难。确切的诊断始终基于组织学或微生物学证据。由于分子生物学和快速培养技术的发展,一些最新进展应能实现更快速的微生物学诊断。与工业化国家一样,发展中国家的死亡率和发病率仍然很高,而且发生肺外结核病的临床情况往往会使预后恶化。