II. Distribution: Areas of Dissemination
-
Tuberculous Lymphadenitis or Scrofula (most common non-pulmonary form)
- Cervical Lymphadenopathy is most common
- Swollen and matted nodes that may drain
- Pleural Tuberculosis (5%) and Pleural Effusions
-
Skeletal Tuberculosis (35%)
- Thoracic and Lumbar Spine involvement of intervertebral discs and Vertebrae (Pott's Disease)
- Chronic Monoarthritis may also occur
-
Tuberculous Meningitis (with CNS Granulomas)
- CSF with moderate Lymphocytosis
- Gastrointestinal Tuberculosis
- Genitourinary Tuberculosis
- Tuberculous Peritonitis
- Tuberculous Pericarditis and Pericardial Effusion
- Miliary Tuberculosis (Disseminated tuberculosis)
- Named for its tiny Millet Seed sized Granulomas widely distributed (similar to shotgun pellets)
- Seen in AIDS and untreated Tuberculosis
- Presents with fever, Night Sweats, weight loss
- PPD is positive in only 50% of cases
III. Management
- See Active Tuberculosis
- Duration of therapy (phase 1 and 2 combined)
- Most forms of Extrapulmonary Tuberculosis: 4-7 months
- CNS Tuberculosis: 9-12 months
- Musculoskeletal Tuberculosis: Extended duration
- Phase 1: First 2 months (altered if suspect resistance)
- Phase 2: Duration varies per guidelines above