Pulmonary and Hepatic Tuberculosis in a Single Individual
Authors: Pedada Mounika  , Ghanshvam Verma  , Elen Ann Abraham  , Sompalli Sri Harshith  , Goli Snehitha Reddy  
Published: September 2024

Tuberculosis (TB) is a contagious bacterial infection caused by the Mycobacterium tuberculosis bacterium. It primarily affects the lungs but can also target other parts of the body, known as extra pulmonary tuberculosis (EPTB). TB spreads through the air when an infected person coughs, sneezes, or talks.[1]
Asia bears a significant burden of TB cases worldwide, accounting for approximately 60% of the global TB incidence. The region's large population, varying health systems, and socioeconomic factors contribute to this high prevalence. Countries like India, China, Indonesia, and Bangladesh have particularly high TB rates.[1,2]
India has the highest number of TB cases globally, making it a major concern for public health. Factors such as poverty, overcrowding, inadequate healthcare infrastructure, and limited access to diagnostics and treatment contribute to the high prevalence. The Indian government has implemented various initiatives to combat TB and improve prevention, diagnosis, and treatment services.[3]
Despite the rapid decline in tuberculosis (TB) prevalence globally following the introduction of anti-TB medications in the 1940s, recent years have witnessed a resurgence in TB incidence rates. This resurgence can be attributed to various factors including governmental complacency, inadequate public health interventions, HIV coinfection, intravenous drug abuse, multidrug resistance, and an increasing number of immunocompromised individuals.[1] As a consequence, hepatic tuberculosis, which is part of disseminated tuberculosis, has been observed in 50-80% of cases, reflecting the growing prevalence of TB. Hepatic TB often presents challenges in clinical diagnosis due to its atypical symptoms and imaging findings, leading to potential misdiagnosis and delayed treatment initiation.[2-3] Through our literature review, it became apparent that the majority of existing studies are comprised of case reports, highlighting a lack of comprehensive understanding in diagnosing and treating hepatic tuberculosis.[4]
An immunocompromised host refers to an individual with a weakened immune system, making them more susceptible to infections and diseases. This can result from conditions such as HIV/AIDS, chemotherapy, organ transplantation, or certain medications that suppress the immune response.[5]
Immunocompromised individuals face a higher risk of contracting TB due to their weakened immune defenses. The risk of developing active TB disease is significantly increased in this population. Timely diagnosis and appropriate management are crucial to prevent serious complications and mortality.[5]
In immunocompromised hosts, TB can manifest in various extra pulmonary sites outside the lungs. Common sites of EPTB involvement include the lymph nodes, bones and joints, central nervous system, genitourinary system, gastrointestinal tract, and skin. Prompt recognition and appropriate treatment are essential to prevent complications and morbidity associated with EPTB.[6]
By understanding the prevalence of TB in Asia and India, the impact on immunocompromised individuals, the definition   of disseminated TB, and the sites of EPTB in immunocompromised hosts, we can better address and manage this public health issue. Increased awareness, early diagnosis, and effective treatment strategies are crucial in reducing the burden of TB and improving patient outcomes.[7]