Diagnostic dilemma in extra-pulmonary tuberculosis: PCR a convenient tool

Ratna Shukla, Anil Kumar Bilolikar, Sukrutha Gopal Reddy

Pdf Page Numbers :- 97-102

Ratna Shukla^1,*, Anil Kumar Bilolikar¹ and Sukrutha Gopal Reddy¹

¹Department of Microbiology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Ratna Shukla, Department of Microbiology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: ratnashukla8@gmail.com

Received 17 July 2018; Revised 31 August 2018; Accepted 10 September 2018; Published 18 September 2018

Citation: Shukla R, Bilolikar AK, Reddy SG. Diagnostic dilemma in extra-pulmonary tuberculosis: PCR a convenient tool. J Med Sci Res. 2018; 6(4):97-102. DOI: http://dx.doi.org/10.17727/JMSR.2018/6-17

Copyright: © 2018 Shukla R et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Mycobacterium tuberculosis infection usually manifests as pulmonary tuberculosis and rarely as extra-pulmonary tuberculosis (EPTB). In recent past, there is an increase in the cases of extra-pulmonary tuberculosis. The diagnostic difficulty owing to paucibacillary nature of EPTB poses a challenge in diagnosis and consequently treatment. In this scenario, Polymerase chain reaction (PCR) serves as a convenient tool which gives results within a short time along with other conventional methods in the diagnosis of extra-pulmonary tuberculosis.

Aims: To detect Mycobacterium tuberculosis complex (MTBC) by DNA PCR in clinically suspected cases of EPTB.

Materials and methods: Clinical samples from suspected cases of EPTB were collected and processed according to the standard guidelines. Smears prepared were subjected to Ziehl-Neelsen (ZN) staining. Nested PCR was performed on extracted DNA from homogenized samples using commercial kit with MTB target gene of IS6110.

Results: A total of 156 samples were received for molecular diagnosis of EPTB over a year. They were all subjected to ZN staining and PCR test. All 156 samples were negative for AFB by ZN staining. Out of total 156 samples, 8(5.12%) samples were detected positive by MTB-DNA PCR test. The most common site of EPTB found in this study was pleura (14.28%). Other sites included genito-urinary tract (13.33%), CNS (4.65%) and endometrium (3.44%).

Conclusion: Early diagnosis and treatment of EPTB reduces complications and morbidity in affected patients. Though PCR is expensive; in diagnostic dilemma in suspected cases of EPTB, it can be included in diagnostic panel to clinch the diagnosis early and start pre-emptive treatment.

Keywords: Extra-pulmonary tuberculosis; MTB DNA-PCR; ZN staining; MTBC