Extrapulmonary Tuberculosis LU

Extrapulmonary Tuberculosis is a

TB infection outside the lungs

Tuberculosis can be spread to sites outside the lungs via

- lymphatic system

- vascular system

Approximately how many people with pulmonary TB infections will develop extrapulmonary (disseminated) TB

10-15%

Tuberculosis likes to disseminate to the

skeletal system

If the involvement of the skeletal system is going to occur, it usually does so

a few years after the primary infection of the lungs

Common skeletal sites to develop Extrapulmonary TB: Vertebral bodies

- Extrapulmonary TB in the lumbar or thoracic spine is called Pott's disease

- Involvement of the cervical spine is possible but less common than the thoracic or lumbar spine

Common skeletal sites to develop Extrapulmonary TB: Vertebral bodies, Abscesses can lead to

the collapse of the vertebral body and this can be significant enough to cause paralysis if it impinges on the spinal cord

Common skeletal sites to develop Extrapulmonary TB: Lower Extremities

- hips

- knees

- ankles

Common skeletal sites to develop Extrapulmonary TB: Upper Extremities

Wrist

Medical management for Extrapulmonary TB is the same for Pulmonary TB relative to

the use of antibiotics

Extrapulmonary TB Medical Management: depending on the response to antibiotics

surgical debridement and irrigation are sometimes used

Extrapulmonary TB Medical Management: In severe cases

fractures and deformities are addressed surgically

Extrapulmonary TB Medical Management: Critical Piece

getting the pt to take a full course of antibiotics

Extrapulmonary TB Medical Management: TB is tough bacteria to kill, some medication plans require

6-9 months of consistent use

Extrapulmonary TB Medical Management: Not taking full course of antibiotics

- reduces the likelihood of cure

- leads to antibiotic-resistant strains of TB

Two major PT implications for Extrapulmonary TB

- awareness of risk factors

- self protextion

Patients at higher risk for TB and Extrapulmonary (disseminated) TB:

- w/ AIDS/HIV infections

- recently incarcerated (TB more common in prison pop)

- recently immigrated from TB endemic regions of the world

- homeless and/or live in overcrowded conditions w/ poor water and waste systems

PTs should

follow TB precautions if they are working w/ a pt known to have TB