title: Evaluation of pulmonary and extrapulmonary tuberculosis in immunocompetent adults: a retrospective case series analysis.
abstract: OBJECTIVE
  It was the aim of this study to evaluate the demographic factors and clinical features of extrapulmonary tuberculosis (EPTB) compared to those of pulmonary tuberculosis (PTB) among adult immunocompetent patients.
  
  
  METHODS
  A total of 427 patients with clinically, radiologically and histopathologically confirmed TB were enrolled in the study, in our clinic at a tertiary care hospital in Turkey, during a 5-year period (2007-2012). Patient data were obtained retrospectively. Among the 427 patients, 55 patients with both PTB and EPTB and who were using steroids or had taken immunosuppressive drugs were excluded from the study.
  
  
  RESULTS
  Of the 372 patients, 227 (61%) were males and 168 (45.2%) had EPTB; 204 (54.8%) patients had PTB. The most frequent sites of EPTB were the lymph nodes (n = 45, 12.1%), pleura (n = 40, 10.7%) and brain (n = 7, 1.8%). The most common symptoms were cough (n = 174, 46.7%), night sweats (n = 127, 34.1%) and fever (n = 123, 33%). Compared to EPTB patients, PTB patients were less likely to have received Bacillus Calmette-Guérin vaccination (odds ratio 0.41, 95% confidence interval 0.2-0.63; p < 0.001). Eighty-one (48.2%) of the EPTB and 146 (71.6%) of the PTB patients were males. Pulmonary involvement was more common among men (n = 146, 71.6%) than among women (n = 58, 28.2%; p = 0.000).
  
  
  CONCLUSIONS
  There was a high incidence of EPTB in our study. Early diagnosis of EPTB is crucial for treatment, and atypical presentations of TB should be kept in mind for immunocompetent patients living in endemic areas. Females especially should be investigated for EPTB.
authors.affiliation: Department of Infectious Diseases, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
authors.forename: Selma Ates
authors.initials: SA
authors.lastname: Guler
authors.forename: Fulsen
authors.initials: F
authors.lastname: Bozkus
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Inci
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Kokoglu
authors.forename: Hasan
authors.initials: H
authors.lastname: Ucmak
authors.forename: Sevinc
authors.initials: S
authors.lastname: Ozden
authors.forename: Murvet
authors.initials: M
authors.lastname: Yuksel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001500:BCG Vaccine / Q000008:administration & dosage; D015897:Comorbidity; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D014397:Tuberculosis, Pulmonary; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001500:BCG Vaccine