• Investigative Magnetic Resonance Imaging
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• v.26 no.1
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• pp.71-75
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• 2022

Tuberculous epididymo-orchitis, a rare form of extrapulmonary tuberculosis, results from hematogenous dissemination or retrograde extension from the lower urinary tract. Herein, we studied the case of a 22-year-old male patient who presented with refractory left scrotal pain and inflammation. The patient also complained of multifocal pain involving the right buttock, posterior thigh, and right wrist, without trauma history. The patient was diagnosed with multifocal tuberculosis by sputum AFB study and right sacroiliac joint biopsy.

• Tuberculosis and Respiratory Diseases
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• v.72 no.6
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• pp.475-480
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• 2012

Background: Pyrazinamide (PZA) is an effective antitubercular drug that becomes toxic to Mycobacterium tuberculosis when converted to pyrazinoic acid by pyrazinamidase (PZase), encoded by mycobacterial pncA. A strong association was noted between the loss of PZase activity and PZA resistance. The causative organisms in extrapulmonary tuberculosis are rarely cultured and isolated. To detect pncA mutations in specimens from extrapulmonary tuberculosis as confirmative diagnosis of mycobacterial infection and alternative susceptibility test to PZA. Methods: Specimens were collected from clinically proven extrapulmonary tuberculosis. pncA was sequenced and compared with wild-type pncA. Results: pncA from 30 specimens from 23 donors were successfully amplified (56.6% in specimens, 59% in donors). Six mutations in pncA were detected (20.0% in amplified specimens, 26.1% in specimen donors) at nucleotide positions of 169, 248 and 419. The mutation at position 169 results in substitution of aspartic acid for histidine, a possible allelic variation of M. bovis that have intrinsic PZA resistance. The mutation at position 248 changes proline into arginine and that at position 419, arginine into histidine. Conclusion: DNA-based diagnosis using pncA may be simultaneously useful for the early diagnosis of mycobacterial infection and the rapid susceptibility to PZA in extrapulmonary tuberculosis. A potential implication of pncA allelic variation at 169 might be suggested as a rapid diagnostic test for M. bovis infection or Bacille Calmette-Gu$\acute{e}$rin (BCG) reactivation.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.39-42
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• 2017

Tuberculosis is primarily a pulmonary disease and extrapulmonary involvement of the oral cavity is an infrequent occurrence accounting for 0.2 - 1.5% of all extrapulmonary sites. The authors report a case of primary tuberculosis of the oral tongue in a 60-years-old male patient who visited the clinic for ongoing tongue pain that he experienced for several months. The lesion was initially indistinguishable from the malignancy, but differential diagnosis was performed on the biopsy with Ziehl-Neelseen stain. After treatment with anti-tuberculosis, the oral lesion healed completely without surgery.

• Tuberculosis and Respiratory Diseases
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• v.78 no.2
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• pp.47-55
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• 2015

Extrapulmonary tuberculosis (EPTB) constitutes about 20% of all cases of tuberculosis (TB) in Korea. Diagnosing EPTB remains challenging because clinical samples obtained from relatively inaccessible sites may be paucibacillary, thus decreasing the sensitivity of diagnostic tests. Whenever practical, every effort should be made to obtain appropriate specimens for both mycobacteriologic and histopathologic examinations. The measurement of biochemical markers in TB-affected serosal fluids (adenosine deaminase or gamma interferon) and molecular biology techniques such as polymerase chain reaction may be useful adjuncts in the diagnosis of EPTB. Although the disease usually responds to standard anti-TB drug therapy, the ideal regimen and duration of treatment have not yet been established. A paradoxical response frequently occurs during anti-TB therapy. It should be distinguished from other causes of clinical deterioration. Surgery is required mainly to obtain valid diagnostic specimens and to manage complications. Because smear microscopy or culture is not available to monitor patients with EPTB, clinical monitoring is the usual way to assess the response to treatment.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.196-200
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• 2000

Nasopharyngeal tuberculosis is a rare pathological condition. It is most often associated with lymph node and pulmonary lesions, but it may be an isolated lesion. The clinical manifestation may resemble a malignant tumor of the nasopharynx and the nasopharyngeal tuberculosis is occurred occasionally primary infection but more frequently secondary infection to pulmonary tuberculosis. The nasal endoscopic evaluation of nasopharynx is necessary in patient with possible pulmonary or extrapulmonary tuberculosis. The author reports two cases of nasopharyngeal tuberculosis in a 45-years old and 34-years old woman with a review of the literature.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.62-72
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• 1992

Background: T-cell mediated cellular immunity has been suggested as an important mechanism in mycobacterial infection and imbalance between helper/inducer and suppressor/cytotoxic T-cell has been suggested as an important immunological abnormality in the pathogenesis of tuberculosis in human. Method: To determine whether there is any difference in T-cell mediated immunity in the pathogenesis of pulmonary and extra pulmonary tuberculosis, total numbers of WBC&lymphocytes were counted and helper/inducer and suppressor/cytotoxic cells were calculated by flow cytometry. Blastogenesis after stimulation with Concanavalin-A, Phytohemagglutinin and PPD were measured by $^3H$-thymidine uptake. PPD skin test was performed as an in vivo test. Results: 1)There was no significant difference in the size of PPD skin test between pulmonary and extrapulmonary tuberculosis groups. 2)Number of total lymphocytes significantly decreased in tuberculosis patients compared with healthy control group. But there was no significant difference between pulmonary and extrapulmonary tuberculosis groups. 3) Number of HLA-DR and Interleukin-2 receptor (+) cells were significantly increased in tuberculosis patients. But there was no significant difference between pulmonary and extra pulmonary tuberculosis groups. 4) There was no significant difference in the numbers of WBC, $T_3$, $T_4$ and $T_8$ lymphocytes and $T_4/T_8$ ratio between tuberculosis patients and healthy controls. 5) There was no significant difference in the blastogenesis after stimulation with specific and non-specific blastogens between tuberculosis patients and healthy controls. 6) The percentage and absolute number of $T_4$ lymphocyte were significantly correlated with the size of PPD skin test. (r=0.689 and 0.598). Conclusion: From these results, it is concluded that there was no difference in T-cell mediated immunity between pulmonary and extra pulmonary tuberculosis group. But, because it is suspected that there might be some difference in the role of T-cell mediated immunity in the pathogenesis of pulmonary and extra pulmonary tuberculosis or even among the extrapulmonary tuberculosis patients, further studies would be required.

• Tuberculosis and Respiratory Diseases
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• v.76 no.4
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• pp.153-159
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• 2014

Tuberculous pleurisy is the most common form of extrapulmonary tuberculosis in Korea. Tuberculous pleurisy presents a diagnostic and therapeutic problem due to the limitations of traditional diagnostic tools. There have been many clinical research works during the past decade. Recent studies have provided new insight into the tuberculous pleurisy, which have a large impact on clinical practice. This review is a general overview of tuberculous pleurisy with a focus on recent findings on the diagnosis and management.

• Journal of Yeungnam Medical Science
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• v.11 no.2
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• pp.240-247
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• 1994

To evaluate the isolation rate of acid-fast bacilli on Ziehl-Neelsen stain from biopsy specimens of extrapulmonary tuberculosis proven by chronic granulomatous inflammation, 286 cases of extrapulmonary tuberculosis were reviewed and the results are as follows: 1) Mean age was 27.3 years old and lymphatic tuberculosis was more prevalent in the female but others were more common in the male. 2) The most common site of extrapulmonary tuberculosis was pleura (103 cases;36%) followed by lymph nodes (87 cases;30.4%), gastrointestinal tract (27 cases;9.4%), skin and soft tissue (23 cases;8.0%), bone (19 cases; 6.6%), urinary tract (14 cases;4.6%), larynx (9 cases;3.2%) and breast (5 cases;1.8%) in order of frequencies. 3) Of 286 cases, 30.4% (87 cases) of the biopsy specimens showed acid fast bacilli on microscopy. The isolation rate according to the sites was slightly higher in breast and lymph nodes as 3 of 5 cases (60.0%) and 35 of 87 cases (40.2%) respectively, and followed by 3 of 9 cases (33.3%) in the larynx, 4 of 13 cases (30.8%) in the urinary tract, 5 of 19 cases (26.3%) in the bone, 7 of 27 cases (25.9%) in the gastrointestinal tract, 26 of 103 cases (25.2%) in the pleura, and 4 of 23 cases (17.4%) in the skin and soft tissue, in order of frequencics. 4) The prevalence of extrapulmonary tuberculosis associated with pulmonary tuberculosis on chest X-ray was 85 of 286 cases (29.7%).

• Journal of Korean Neurosurgical Society
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• v.39 no.6
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• pp.451-454
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• 2006

We present a case of a 68-year-old female with an atypical form of spinal tuberculosis, which involved posterior elements with multiple foci in two noncontiguous vertebral levels. The lesions caused spastic paraparesis and urinary hesitation. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. Based on clinical and radiographic findings, this atypical spinal tuberculosis was preoperatively misdiagnosed as metastatic spine tumor. The histopathologic finding confirmed tuberculosis and the patient was treated successfully with surgery and antituberculous therapy. In case of a spinal lesion of unknown origin, it is important to be aware that atypical spinal tuberculosis can mimic metastatic spine tumor and tuberculosis should always be considered.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.482-484
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• 2008

It is well known that F18-FDG PET/CT is a highly sensitive diagnostic modality for cancer patients. However, false positive cases resulting from benign disease such as tuberculosis in the endemic area often compromise the diagnostic accuracy of F18-FDG PET/CT. Nasopharyngeal tuberculosis is a rare disease although extrapulmonary tuberculosis can involve any region in the body. We report one case of nasopharyngeal tuberculosis incidentally detected on F18-FDG PET/CT.