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Mycobacterium tuberculosis

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 30 October 2026 · Methodology

Mycobacteriaceae · Acid-fast

Déclaration obligatoire. Première cause de décès par maladie infectieuse dans le monde ; en France, maladie devenue peu fréquente mais encore présente. TB pulmonaire : la plus fréquente et la plus contagieuse si BK+ à l'examen direct. Isolement respiratoire immédiat (chambre à pression négative si possible). GeneXpert MTB/RIF : test moléculaire rapide — sensibilité, spécificité et délai absents de Nahid 2016 (recommandation de traitement) ; not verified. Traitement TB pulmonaire sensible : RHZE (duration not verified) + RH (duration not verified) (WHO 2022) — see cited source. TB-MDR (résistante rifampicine + isoniazide) : hors du champ des sources citées, qui portent sur la tuberculose sensible — not verified. BK ultrarésistant (XDR) : pronostic très sévère.

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Mycobacterium tuberculosis are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Lung	High tropism	Evidence B	2	not recorded
Bones / Joints (mal de Pott)	High tropism	Evidence B	2	not recorded
Meninges	High tropism	Evidence A	2	hematogenous
Central nervous system — Tuberculomes cérébraux	Moderate tropism	Evidence D (unsourced)	0	hematogenous
Kidney	Moderate tropism	Evidence C	1	not recorded
Lymph nodes (miliaire)	Moderate tropism	Evidence C	1	not recorded
Heart / Endocardium	Rare tropism	Evidence A	2	not recorded
Eye — Uvéite / Choroïdite tuberculeuse	Rare tropism	Evidence C	1	hematogenous

Described portals of entry

• Lung

Spread routes recorded: 3 of 8 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Associated syndromes

• Bacterial meningitis
• Community-acquired pneumonia (CAP)
• Septic arthritis and osteomyelitis

Sources

• WHO — Consolidated guidelines on tuberculosis, module 4: treatment — drug-susceptible tuberculosis treatment (2022) — https://www.who.int/publications/i/item/9789240048126
• Nahid P et al. — IDSA Official American Thoracic Society/CDC Practice Guidelines: Treatment of Drug-Susceptible TB (CID) (2016) — doi:10.1093/cid/ciw376
• Tuli SM — Tuberculosis of the spine: a historical review (Clin Orthop Relat Res) (2007) — doi:10.1097/blo.0b013e318065b75e
• Thwaites GE et al. — Dexamethasone for tuberculous meningitis (NEJM) (2004) — doi:10.1056/NEJMoa040573
• Figueiredo AA & Lucon AM — Epidemiology of urogenital tuberculosis worldwide (Int J Urol) (2008) — doi:10.1111/j.1442-2042.2008.02099.x
• Sharma SK et al. — Miliary tuberculosis: new insights into an old disease (Lancet Infect Dis) (2005) — doi:10.1016/s1473-3099(05)70163-8
• Mayosi BM et al. — Prednisolone and Mycobacterium indicus pranii in tuberculous pericarditis (NEJM) (2014) — doi:10.1056/NEJMoa1407380
• Gupta V et al. — Intraocular tuberculosis — an update (Surv Ophthalmol) (2007) — doi:10.1016/j.survophthal.2007.08.015

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