- lymphadenitis,
- pericarditis,
- peritonitis,
- CNS disease including meningitis,
- GU tract disease
- ± sterile pyuria,
- osteoarticular disease (vertebral = Pott’s disease),
- granulomatous hepatitis, splenitis, cutaneous disease
Workup
- Pleural/pericardial effusions or ascites:
- fluid sampling for AFB cx/smear, NAAT/ PCR, cell counts.
- Adenosine deaminase (ADA) can be ↑, best validated in ascites.
- Free INFγ can be elevated in pleural/ascitic fluid (not validated in pericardial effusions).
- Higher diagnostic yield with pleural/pericardial biopsies for disease at these sites.
- CSF:
- fluid sampling for AFB cx/smear (submit at least 10 mL),
- NAAT/PCR,
- cell count ( NB: lymphocyte predominanace),
- glucose (low),
- protein (high),
- ADA (high)
- Soft tissue:
- tissue biopsy with AFB staining,
- pathology w/ granulomas