Die Tuberkulose bleibt trotz moderner Medizin eine der tödlichsten Infektionskrankheiten
weltweit. Neben der klassischen Lungenerkrankung tritt in bis zu 25% der Fälle eine
extrapulmonale Form auf – oft schwer zu erkennen, teilweise mit gravierenden Folgen.
Der Beitrag beleuchtet Epidemiologie, Klinik, Diagnostik und Therapie dieses heterogenen
Krankheitsbilds und zeigt aktuelle Herausforderungen auf.
Abstract
In 2023, tuberculosis (TB) caused 1.25 million deaths among 10.8 million cases, remaining
the deadliest infectious disease worldwide. In Germany, incidence declined for decades
but rose slightly in 2022–2023, driven mainly by migration from high-prevalence countries
(e.g., Syria, Afghanistan, Ukraine). While most cases are pulmonary TB (PTB), 22.8%
are extrapulmonary TB (EPTB), which can affect any organ and is often hard to diagnose
due to nonspecific symptoms. Diagnosis uses microscopy, PCR, and culture; treatment
typically lasts at least 6 months, extended for CNS, bone, or miliary TB. Treatment
response is assessed clinically and radiologically; reliable blood-based markers are
urgently needed.
Schlüsselwörter
extrapulmonale Tuberkulose - Epidemiologie - Diagnostik - Therapie
Keywords
extrapulmonary tuberculosis - epidemiology - diagnosis - therapy
