Evaluation of Extra Pulmonary Tuberculosis in a Tertiary Care Centre in Kerala, South India, Utilising GeneXpert

Even as pulmonary tuberculosis presents significant diagnostic challenges, diagnosis of extrapulmonary tuberculosis can be even more challenging. 1145 extrapulmonary samples were tested over a period of 2years, out of which Mycobacterium tuberculosis was detected in 144samples (12.6%). Samples included pleural fluid, lymph node aspirate & biopsy, cerebrospinal fluid and other sterile body fluids, synovial biopsy, ileocaecal biopsy and pus aspirates from abscess. Rifampicin resistance was detected in 6samples (5 lymph node aspirates and 1 pleural fluid). All 6 were first line treatment failure cases who were started on second line antituberculous treatment. Xpert® MTB/RIF assay was found to be highly useful for diagnosis of lymph node tuberculosis and least for diagnosing tuberculous effusions.