PCR DETECTION OF MYCOBACTEREMIA IN TANZANIAN PATIENTS WITH EXTRAPULMONARY TUBERCULOSIS

In 191 Tanzanian patients admitted to hospital with suspected extrapul monary tuberculosis (TB), TB was diagnosed in 158 patients; the remain ing 33 patients had neither microbiological nor clinical evidence of T B. Mycobacterium tuberculosis was detected in the blood of 25 patients , in 92% by a polymerase chain reaction (PCR) technique and in 52% by culture of buffy coat cells. The presence of mycobacterial DNA or Myco bacterium tuberculosis bacteria in peripheral blood (positive culture) was significantly associated with HIV infection; it was detected in 2 2 (21.4%) of 103 HIV-seropositive patients compared to only 3 (3.5%) o f 55 HIV-seronegative patients (p < 0.009). In two-thirds of the patie nts with mycobacteraemia, TB can be detected by simple smears from oth er organ sites. In patients with suspected extrapulmonary tuberculosis in whom smears from the infected site are negative or not available, PCR on blood will confirm the diagnosis within 24 hours in one third o f the cases.