{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:05:00Z","timestamp":1790150700230,"version":"4.0.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In this retrospective cohort of non-HIV patients without pharmacological immunosuppression, who presented with extrapulmonary\/disseminated tuberculosis, the gastrointestinal tract, lymph nodes, and genitourinary tract were the most commonly affected organs. 24-month all-cause mortality was 18%. Cardiovascular disease, central nervous system involvement, mycobacteremia, and ICU admission were independently associated with death.<\/jats:p>","DOI":"10.1093\/ofid\/ofag576","type":"journal-article","created":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T13:53:45Z","timestamp":1788616425000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of People With Extrapulmonary and Disseminated Tuberculosis: A 23-Year Retrospective Cohort Study in People Without HIV Without Pharmacological Immunosuppression"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5256-3858","authenticated-orcid":false,"given":"Brenda","family":"Aceves-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7809-9619","authenticated-orcid":false,"given":"Sandra","family":"Rajme-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5191-2179","authenticated-orcid":false,"given":"Bernardo A","family":"Mart\u00ednez-Guerra","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9735-3892","authenticated-orcid":false,"given":"Hector O","family":"Rivera-Villegas","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2509-618X","authenticated-orcid":false,"given":"Carla M","family":"Rom\u00e1n-Montes","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6322-1079","authenticated-orcid":false,"given":"Karla M","family":"Tamez-Torres","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz E","family":"Gonz\u00e1lez-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Guadarrama-Torres","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oswaldo","family":"Lazcano-Delgadillo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-2354","authenticated-orcid":false,"given":"Rafael","family":"Nares-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zurisadai","family":"Segura-Ort\u00edz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M","family":"Tepo-Ponce","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0292-3442","authenticated-orcid":false,"given":"Mar\u00eda F","family":"Gonz\u00e1lez-Lara","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]},{"name":"Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara","family":"Ch\u00e1vez-Mazari","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1184-827X","authenticated-orcid":false,"given":"Miriam","family":"Bobadilla-del-Valle","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9584-1360","authenticated-orcid":false,"given":"Jos\u00e9","family":"Sifuentes-Osornio","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n General Direction, , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo","family":"Ponce-de-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"2026092303270629000_ofag576-B1","volume-title":"Global tuberculosis report 2025","author":"WHO","year":"2025"},{"key":"2026092303270629000_ofag576-B2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jctube.2016.03.003","article-title":"Miliary tuberculosis: a new look at an old foe","volume":"3","author":"Sharma","year":"2016","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"key":"2026092303270629000_ofag576-B3","first-page":"S1473-3099(26)00295-1","article-title":"Global, regional, and national burden of tuberculosis and multidrug-resistant tuberculosis by HIV status, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023","author":"GBD 2023 TB HIV Collaborators","year":"2026","journal-title":"Lancet Infect Dis"},{"key":"2026092303270629000_ofag576-B4","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1471-2334-14-9","article-title":"Epidemiology of extrapulmonary tuberculosis in Brazil: a hierarchical model","volume":"14","author":"Gomes","year":"2014","journal-title":"BMC Infect Dis"},{"key":"2026092303270629000_ofag576-B5","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S1473-3099(17)30703-X","article-title":"The global burden of tuberculosis: results from the Global Burden of Disease Study 2015","volume":"18","author":"GBD Tuberculosis Collaborators","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"2026092303270629000_ofag576-B6","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.3390\/microorganisms13112453","article-title":"Molecular epidemiology of Mycobacterium tuberculosis in Mexico","volume":"13","author":"Rodr\u00edguez-Mart\u00ednez","year":"2025","journal-title":"Microorganisms"},{"key":"2026092303270629000_ofag576-B7","volume-title":"Situaci\u00f3n epidemiol\u00f3gica m\u00e9xico","author":"CENAPRECE","year":"2022"},{"key":"2026092303270629000_ofag576-B8","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/jfcm.JFCM_106_18","article-title":"Review of literature on disseminated tuberculosis with emphasis on the focused diagnostic workup","volume":"26","author":"Khan","year":"2019","journal-title":"J Family Community Med"},{"key":"2026092303270629000_ofag576-B9","doi-asserted-by":"crossref","first-page":"ofae739","DOI":"10.1093\/ofid\/ofae739","article-title":"Risk factors for disseminated tuberculosis and associated survival in adults without human immunodeficiency virus","volume":"12","author":"Huang","year":"2025","journal-title":"Open Forum Infect Dis"},{"key":"2026092303270629000_ofag576-B10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/MD.0b013e318030b605","article-title":"Disseminated tuberculosis: a 10-year experience in a medical center","volume":"86","author":"Wang","year":"2007","journal-title":"Medicine (Baltimore)"},{"key":"2026092303270629000_ofag576-B11","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1038\/s41426-018-0106-1","article-title":"Risk factors for extrapulmonary dissemination of tuberculosis and associated mortality during treatment for extrapulmonary tuberculosis","volume":"7","author":"Qian","year":"2018","journal-title":"Emerg Microbes Infect"},{"key":"2026092303270629000_ofag576-B12","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/jfcm.JFCM_106_18","article-title":"Review of literature on disseminated tuberculosis with emphasis on the focused diagnostic workup","volume":"26","author":"Khan","year":"2019","journal-title":"J. Family Community Med"},{"key":"2026092303270629000_ofag576-B13","doi-asserted-by":"crossref","first-page":"118","DOI":"10.4103\/1817-1737.33700","article-title":"Extrapulmonary tuberculosis in non-human immunodeficiency virus-infected adults in an endemic region","volume":"2","author":"Ozvaran","year":"2007","journal-title":"Ann Thorac Med"},{"key":"2026092303270629000_ofag576-B14","doi-asserted-by":"crossref","first-page":"ofaf239","DOI":"10.1093\/ofid\/ofaf239","article-title":"Distinct clinical features of extrapulmonary and disseminated tuberculosis in HIV- and non-HIV-associated immunosuppression: a retrospective cohort study","volume":"12","author":"Aceves-S\u00e1nchez","year":"2025","journal-title":"Open Forum Infect Dis"},{"key":"2026092303270629000_ofag576-B15","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0732-8893(03)00138-X","article-title":"Evaluation of sputum decontamination methods for Mycobacterium tuberculosis using viable colony counts and flow cytometry","volume":"47","author":"Burdz","year":"2003","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2026092303270629000_ofag576-B16","first-page":"e59739","article-title":"Factors associated with extrapulmonary tuberculosis in Southeastern Mexico: a case-control study","volume":"16","author":"Luna-Hern\u00e1ndez","year":"2024","journal-title":"Cureus"},{"key":"2026092303270629000_ofag576-B17","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s10096-008-0649-5","article-title":"Frequency of Mycobacterium bovis as an etiologic agent in extrapulmonary tuberculosis in HIV-positive and -negative Mexican patients","volume":"28","author":"Cicero","year":"2009","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2026092303270629000_ofag576-B18","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1186\/s12879-016-2001-5","article-title":"Human tuberculosis caused by Mycobacterium bovis: a retrospective comparison with Mycobacterium tuberculosis in a Mexican tertiary care centre, 2000-2015","volume":"16","author":"Torres-Gonzalez","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2026092303270629000_ofag576-B19","doi-asserted-by":"crossref","first-page":"899","DOI":"10.3201\/eid1906.120543","article-title":"Zoonotic Mycobacterium bovis-induced tuberculosis in humans","volume":"19","author":"M\u00fcller","year":"2013","journal-title":"Emerg Infect Dis"},{"key":"2026092303270629000_ofag576-B20","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/S1473-3099(05)70163-8","article-title":"Miliary tuberculosis: new insights into an old disease","volume":"5","author":"Sharma","year":"2005","journal-title":"Lancet Infect Dis"},{"key":"2026092303270629000_ofag576-B21","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1186\/s12879-019-4312-9","article-title":"Treatment outcomes and risk factors of extra-pulmonary tuberculosis in patients with co-morbidities","volume":"19","author":"Khan","year":"2019","journal-title":"BMC Infect Dis"},{"key":"2026092303270629000_ofag576-B22","doi-asserted-by":"crossref","first-page":"e0209650","DOI":"10.1371\/journal.pone.0209650","article-title":"Extra-pulmonary tuberculosis: a retrospective study of patients in Accra, Ghana","volume":"14","author":"Ohene","year":"2019","journal-title":"PLoS One"},{"key":"2026092303270629000_ofag576-B23","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.bjid.2018.10.274","article-title":"Mycobacterium tuberculosis complex bacteremia among HIV and non-HIV patients in a Mexican tertiary care center","volume":"22","author":"Tamez-Torres","year":"2018","journal-title":"Braz J Infect Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag576\/71006145\/ofag576.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag576\/71006145\/ofag576.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag576\/71006145\/ofag576.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:27:18Z","timestamp":1790148438000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag576\/8788749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag576","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,9,1]]},"article-number":"ofag576"}}