Tuberculosis Beyond the Lungs: Understanding Extrapulmonary TB - Dr Anand Vijay

When most people hear the word tuberculosis (TB), they usually think of a lung disease that causes persistent cough and fever. However, doctors emphasize that TB is not limited to the lungs. In a significant number of patients, the infection affects other organs of the body. These forms are known as extrapulmonary tuberculosis (EPTB).

Dr. Anand Vijay explains, “Tuberculosis is caused by the bacterium Mycobacterium tuberculosis, which spreads through the air when an infected person coughs or sneezes. In some patients, the bacteria can spread through the bloodstream or lymphatic system and infect other organs.”

Globally, about 15–20 percent of TB cases occur outside the lungs. In India, where TB remains a major public health challenge, awareness about these forms is important because their symptoms may resemble other common illnesses.

Lymph Node TB – A Common Form

One of the most common forms of extrapulmonary TB affects the lymph nodes, particularly those in the neck. Patients may notice painless swelling or lumps in the neck, sometimes accompanied by mild fever, fatigue, or weight loss. Because these swellings usually grow slowly and are painless, people may delay seeking medical advice.

TB of the Brain – A Serious Condition

Tuberculosis can affect the brain and its covering membranes, causing tuberculous meningitis, a serious condition particularly in children and the elderly. Symptoms may include persistent headache, fever, vomiting, confusion, drowsiness, or seizures. Early diagnosis and prompt treatment are essential to prevent severe complications.

Abdominal TB

TB can involve the intestines, abdominal lymph nodes, or the lining of the abdomen. Common symptoms include persistent abdominal pain, loss of appetite, weight loss, fever, and changes in bowel habits such as diarrhea or constipation. In some cases, abdominal swelling or intestinal blockage may occur.

Bone and Spinal TB

Tuberculosis can affect the bones and joints, most commonly the spine, known as spinal TB (Pott’s disease). Symptoms include persistent back pain, stiffness, and difficulty in movement. If untreated, it can lead to spinal deformity or nerve compression, making early diagnosis crucial.

Genitourinary TB

TB may also affect the kidneys, urinary tract, or reproductive organs. Symptoms may include burning during urination, frequent urination, blood in the urine, or persistent urinary discomfort. These symptoms can resemble common urinary infections and should be evaluated if they persist.

TB of the Eye and Other Organs

In some patients, TB can affect the eyes, causing redness, pain, blurred vision, or sensitivity to light. TB may also involve the lining around the lungs (pleura) or other organs in the body.

Who Is at Higher Risk?

The risk of extrapulmonary TB is higher in people with weakened immunity, including those with diabetes, malnutrition, HIV infection, chronic illnesses, or long-term steroid use. Children and the elderly are also more vulnerable to severe forms of TB.

Importance of Early Diagnosis and Warning Signs

Diagnosing extrapulmonary TB can be challenging as symptoms vary by the organ affected; doctors confirm it through imaging, lab tests, molecular tests like GeneXpert, and biopsy. With early detection and treatment, TB is curable with anti-tuberculosis medicines for several months.

Persistent symptoms such as neck lumps, prolonged fever, weight loss, severe headaches, abdominal or back pain, urinary issues, or eye problems should not be ignored.

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