Universität zu Köln

Klingmüller, Angela, Feldmann, Marie, Rohr, Samuel, Helmhold, Lea, Junker, Lena, Scherer, Margarete, Vehreschild, Jörg-Janne ORCID: 0000-0002-5446-7170, Schmidt-Hellerau, Kirsten ORCID: 0000-0003-4426-9565, Hoffmann, Ada, Jantsch, Jonathan, Simonis, Alexander ORCID: 0000-0003-2945-9897, Suárez, Victor ORCID: 0000-0003-4781-6480, Rauschning, Dominic ORCID: 0000-0001-9284-8778, Funke, Natalie, Malin, Jakob J. ORCID: 0000-0002-2989-0436, Biehl, Lena M. ORCID: 0000-0001-7613-8119, Schommers, Philipp ORCID: 0000-0003-3375-6800, Fätkenheuer, Gerd ORCID: 0000-0002-5054-1871, Lehmann, Clara ORCID: 0000-0002-7042-1578, Rybniker, Jan ORCID: 0000-0001-8351-2690 and Suarez, Isabelle ORCID: 0000-0002-9863-9675 (2025). Clinical heterogeneity and treatment outcomes of extrapulmonary tuberculosis in a low-incidence setting: insights from a prospective cohort study. Infection, 53 (5). pp. 1809-1818. Springer Nature. ISSN 0300-8126

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Abstract

Purpose: Tuberculosis (TB) remains a leading cause of morbidity and mortality, with 1.3 million deaths in 2022. Extrapulmonary tuberculosis (EPTB) accounts for approximately 20% of all TB cases. We assessed the clinical presentation and challenges during the course of treatment in EPTB patients in a low-incidence setting. Methods: We conducted a prospective cohort study involving 44 EPTB patients at the University Hospital of Cologne, Germany. Clinical data were collected before and during treatment. Results: The cohort comprised 44 patients originating from 21 countries. Two or more invasive procedures were required for microbiological confirmation in 59% (26/44) of the cases. Sputum culture was positive in 18% (8/44) of patients, with 63% (5/8) showing no radiological signs of pulmonary involvement. The median therapy duration was ten months and increased with disease severity. Paradoxical reactions (PR) occurred in 31% (13/42) of the patients. A previously published clinical scoring system assessing EPTB treatment responses showed a favorable treatment outcome in only 68% (21/31) of the patients in this cohort. Conclusion: EPTB exhibits highly variable disease severity and organ involvement. Treatment initiation is often delayed due to diagnostic challenges. Management is complicated by the frequent occurrence of PR, which can lead to treatment durations exceeding standard recommendations. Clinical scores for treatment response assessment may not be reliably applicable, highlighting the need for alternative biomarkers.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Klingmüller, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Feldmann, Marie UNSPECIFIED UNSPECIFIED UNSPECIFIED Rohr, Samuel UNSPECIFIED UNSPECIFIED UNSPECIFIED Helmhold, Lea UNSPECIFIED UNSPECIFIED UNSPECIFIED Junker, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherer, Margarete UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Jörg-Janne UNSPECIFIED https://orcid.org/0000-0002-5446-7170 UNSPECIFIED Schmidt-Hellerau, Kirsten UNSPECIFIED https://orcid.org/0000-0003-4426-9565 UNSPECIFIED Hoffmann, Ada UNSPECIFIED UNSPECIFIED UNSPECIFIED Jantsch, Jonathan UNSPECIFIED UNSPECIFIED UNSPECIFIED Simonis, Alexander UNSPECIFIED https://orcid.org/0000-0003-2945-9897 UNSPECIFIED Suárez, Victor UNSPECIFIED https://orcid.org/0000-0003-4781-6480 UNSPECIFIED Rauschning, Dominic UNSPECIFIED https://orcid.org/0000-0001-9284-8778 UNSPECIFIED Funke, Natalie UNSPECIFIED UNSPECIFIED UNSPECIFIED Malin, Jakob J. UNSPECIFIED https://orcid.org/0000-0002-2989-0436 UNSPECIFIED Biehl, Lena M. UNSPECIFIED https://orcid.org/0000-0001-7613-8119 UNSPECIFIED Schommers, Philipp UNSPECIFIED https://orcid.org/0000-0003-3375-6800 UNSPECIFIED Fätkenheuer, Gerd UNSPECIFIED https://orcid.org/0000-0002-5054-1871 UNSPECIFIED Lehmann, Clara UNSPECIFIED https://orcid.org/0000-0002-7042-1578 UNSPECIFIED Rybniker, Jan UNSPECIFIED https://orcid.org/0000-0001-8351-2690 UNSPECIFIED Suarez, Isabelle UNSPECIFIED https://orcid.org/0000-0002-9863-9675 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-797962
Identification Number:	10.1007/s15010-025-02500-4
Journal or Publication Title:	Infection
Volume:	53
Number:	5
Page Range:	pp. 1809-1818
Number of Pages:	10
Date:	11 October 2025
Publisher:	Springer Nature
ISSN:	0300-8126
Language:	English
Faculty:	Central Institutions / Interdisciplinary Research Centers Faculty of Medicine
Divisions:	Faculty of Medicine > Allgemeinmedizin Faculty of Medicine > Innere Medizin > Klinik I für Innere Medizin - Hämatologie und Onkologie Faculty of Medicine > Innere Medizin > Klinik II für Innere Medizin - Nephrologie, Rheumatologie, Diabetologie und Allgemeine Innere Medizin Zentrum für Molekulare Medizin
Subjects:	Medical sciences Medicine
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/79796