Although the prevalence of tuberculosis (TB) in the United States continues to decline (from 2006 to 2007, the total number of TB cases declined 4.2%, from 13,779 cases to 13,293), the rate of decline has slowed in recent years.1 The rate in foreignborn persons is much higher than in US-born persons and appears to be increasing.1
The following cases—Peritoneal TB and Pott Disease—illustrate the importance of maintaining a high clinical suspicion for extrapulmonary TB when caring for patients from regions where TB is endemic who may lack other known risk factors for TB, such as HIV infection. The presence of HIV infection should prompt suspicion of extrapulmonary TB, and all patients with TB should undergo HIV testing. The spine and peritoneum are common extrapulmonary sites of TB; however, any organ may be affected.2
1. Centers for Disease Control and Prevention (CDC). Trends in tuberculosis—United States, 2007. MMWR. 2008;57:281-285.
2. Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. Am Fam Physician. 2005;72:1761-1768.