Extrapulmonary Tuberculosis of patient Visiting Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal

Abstract

Tuberculosis is one of the giant killer disease which accounts for massive death allover the world. Extra pulmonary tuberculosis becomes a serious problem through out the globe including Nepal.The samples were collected and decontaminated and AFB staining as well as culture on Ogawa medium was done. The isolates were identifiedon the basis of biochemical tests.Within the study period from June 2006 to Feb 2007, a total of 150 samples were collected from the patients visited to the Tribhuvan University, Teaching Hospital (TUTH) suspected of Extrapulmonary Tuberculosis. A varieties of Extra pulmonary specimens were brought to the Mycobacteriology laboratory, that includes Urine, Endometrial biopsy, Pleuralfluid, peritoneal fluid, Cerebrospinal fluid, Blood, As citicfluid and Pus. The samples were collected , decontaminated , AFB stained and cultured on Ogawa medium. The isolates were identified on the basis of biochemical tests.Of the total 150 samples, 40 were from male patients and 110 were from female patients.The highest percentage of suspected patients (54.67%) was found in the age group 20-30 followed by 30-40 years. The highest number of female patients 67(60.91%) were found in the age group 21-30 years followed by 12 (10.91%) in 30-40years. Similarly, the highest number of male patients 15 (37.50%) were found in the age group 20-30 years followed by 10 (25.00%) in 30-40 years.The highest number of samples 65 (43.33%) was endometrial biopsy followed by urine 30 (20%). The least number of samples were blood 2 (1.33%).Out of 150 cases of suspected extrapulmonary T.B, only 18 (12%) cases were found to be positive. Among 150 samples, 10 (6.67%) showed positive result from direct smear, 13(8.67%), showed positive result from culture and only 5 (3.33%) were found to be positive from both direct smear and culture.The highest percentage of positive cases9 (49.99%) was found in the age group 20-30 followed by 5 (27.77%) in 10-20 years.The highest number of female patients7 (38.88%) were found in the age group 20-30years followed by 2 (11.11%) in 10-20 years. Similarly, the highest number of male patients 3 (16.66%) were found in the age group 10-20 years followed by 2 (11.11%)in 20-30 years.The highest number of positive cases in both the direct smear examination and culture was obtained from pus sample followed by pleural fluid and urine samples.All the isolated culture tested for Niacin and Nitrate reduction test were found to be positive and negative for heat labile catalase test. Thus, the isolates were confirmed as Mycobacterium tuberculosis.Key Words:Extra pulmonary tuberculosis, Ogawa medium, direct smear, Culture, Mycobacterium tuberculosis.