{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:06:37Z","timestamp":1793045197644,"version":"4.5.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recognizing pulmonary involvement in tuberculosis (TB) patients is necessary to prevent TB transmission. We describe frequency and characteristics of patients with extrapulmonary TB (EPTB), normal chest radiographs, and positive sputum culture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed data of patients \u226515 years of age with EPTB reported to the California TB registry during 2011\u20132017 with cultured sputum and normal chest radiographs using generalized linear modeling to estimate prevalence ratios associated with positive sputum culture. Demographic, behavioral, clinical characteristics, and testing were compared for patients with positive and negative sputum culture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 1635 patients with EPTB and normal chest radiographs, 937 (57%) had sputum culture performed, and 127 (13%) patients had positive results for Mycobacterium tuberculosis complex. Patients with positive results were more likely to: be male, experience homelessness, use substances, have HIV, and have &amp;gt;1 disease site. Among 85 patients with HIV co-infection, 54% had positive culture results compared with 9.5% among 852 patients without HIV co-infection. Patients with EPTB in more than 1 site were also more likely to have a positive sputum culture.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Culturing sputum from patients with EPTB identified pulmonary cases not detected by chest radiograph, particularly among patients with HIV or &amp;gt;1 disease site.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac338","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T19:14:39Z","timestamp":1651605279000},"page":"2113-2118","source":"Crossref","is-referenced-by-count":5,"title":["A Cross-sectional Study of Patients With Extrapulmonary Tuberculosis and Normal Chest Radiographs \u2014 What Characteristics Were Associated With Sputum Culture Positivity?"],"prefix":"10.1093","volume":"75","author":[{"given":"Victoria","family":"Le","sequence":"first","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, California Department of Public Health, Center for Infectious Diseases , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Pascopella","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, California Department of Public Health, Center for Infectious Diseases , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Westenhouse","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, California Department of Public Health, Center for Infectious Diseases , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2962-1890","authenticated-orcid":false,"given":"Pennan","family":"Barry","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, Division of Communicable Disease Control, California Department of Public Health, Center for Infectious Diseases , Richmond, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,5,6]]},"reference":[{"key":"2022121911370371000_ciac338-B1","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B2","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B3","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.5588\/ijtld.14.0319","article-title":"Epidemiology of extra-pulmonary tuberculosis in the United States: high rates persist in the post-HIV era","volume":"18","author":"Adada","year":"2014","journal-title":"Int J Tuberc Lung Dis"},{"key":"2022121911370371000_ciac338-B4","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1086\/605559","article-title":"Epidemiology of extrapulmonary tuberculosis in the United States, 1993\u20132006","volume":"49","author":"Peto","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2022121911370371000_ciac338-B5","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B6","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B7","volume-title":"Treatment of tuberculosis guidelines","author":"World Health Organization","year":"2010"},{"key":"2022121911370371000_ciac338-B8","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B9","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/cid\/ciw778","article-title":"Official American Thoracic Society\/Infectious Diseases Society of America\/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children","volume":"64","author":"Lewinsohn","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2022121911370371000_ciac338-B10","author":"Centers for Disease Control and Prevention"},{"key":"2022121911370371000_ciac338-B11","doi-asserted-by":"crossref","first-page":"88","DOI":"10.4103\/2230-8229.98287","article-title":"Predictors of pulmonary involvement in patients with extra- pulmonary tuberculosis","volume":"19","author":"El-Hazmi","year":"2012","journal-title":"J Family Community Med"},{"key":"2022121911370371000_ciac338-B12","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1378\/chest.08-0319","article-title":"Unexpected pulmonary involvement in extrapulmonary tuberculosis patients","volume":"134","author":"Parimon","year":"2008","journal-title":"Chest"},{"key":"2022121911370371000_ciac338-B13","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1071\/HC14064","article-title":"Pulmonary involvement in patients presenting with extra-pulmonary tuberculosis: thinking beyond a normal chest x-ray","volume":"6","author":"Herath","year":"2014","journal-title":"J Prim Health Care"},{"key":"2022121911370371000_ciac338-B14","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/cid\/cis303","article-title":"Site of extrapulmonary tuberculosis is associated with HIV infection","volume":"55","author":"Leeds","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2022121911370371000_ciac338-B15","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3201\/eid2103.141539","article-title":"Epidemiology of human mycobacterium bovis disease, California, USA, 2003\u20132011","volume":"21","author":"Gallivan","year":"2015","journal-title":"Emerg Infect 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