{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T10:12:48Z","timestamp":1788603168629,"version":"build-2803163510"},"reference-count":0,"publisher":"Greater Baltimore Medical Center","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"abstract":"<jats:p>Background: Extrapulmonary tuberculosis (EPTB) accounts for ~20% of Mycobacterium tuberculosis infections in Pakistan. Diagnostic delays are common and may worsen outcomes. We evaluated whether empiric treatment initiation improves outcomes among patients with EPTB at a large public hospital in Islamabad, Pakistan. Methods: Retrospective cohort of consecutive EPTB cases at Pakistan Institute of Medical Sciences (January\u2013June 2016). Patients were categorized as clinically diagnosed (symptoms\/radiology) or laboratory-supported (histology, microbiology, or biochemical tests). Standard Directly Observed Therapy Short-course (DOTS) based regimens were used. Outcomes were treatment success, failure, loss to follow-up, and mortality; groups were compared using chi-square testing. Results: Of 317 EPTB patients, 275 completed treatment and were analyzed. Mean age was 34.4 years; 57% were male. The most common sites were pleural (28.7%) and lymphatic (20.3%) TB. Clinically diagnosed patients had higher cure rates than laboratory supported diagnosis group patients (87.6% vs. 79.6%; p=0.221) and significantly lower mortality (5.3% vs. 9.3%; p=0.041). Among patients who completed treatment, 82.9% achieved treatment success; overall cure rate was 71% including non-completion and loss to follow-up. Conclusions: Early empiric therapy may be \u00a0associated with improved survival and higher cure rates compared with delaying treatment pending laboratory confirmation. Context-appropriate EPTB guidelines emphasizing prompt clinical treatment are warranted in high burden settings.<\/jats:p>","DOI":"10.55729\/2000-9666.1623","type":"journal-article","created":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:52:13Z","timestamp":1784422333000},"source":"Crossref","is-referenced-by-count":0,"title":["The Effect of Empiric Initiation of Treatment on Outcomes among Patients Presenting with Extrapulmonary Mycobacterium tuberculosis Infection in a Community Hospital Setting"],"prefix":"10.55729","volume":"16","author":[{"given":"Talha","family":"Awwal","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Raja Kh","sequence":"additional","affiliation":[{"name":"American University of Barbados, Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanya","family":"Awaba","sequence":"additional","affiliation":[{"name":"Foundation University Medical College, Rawalpindi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem","family":"Anwar","sequence":"additional","affiliation":[{"name":"Shaukat Khanum Cancer Institute, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinma","family":"Ren","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research, University of Illinois College of Medicine, Peoria, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Aamir","family":"Safdar","sequence":"additional","affiliation":[{"name":"National TB Control Program, Ministry of Health Services, Government of Pakistan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqib","family":"Walayat","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Illinois College of Medicine, Peoria, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"34701","published-online":{"date-parts":[[2026,7,17]]},"container-title":["Journal of Community Hospital Internal Medicine Perspectives"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:52:56Z","timestamp":1788601976000},"score":1,"resource":{"primary":{"URL":"https:\/\/scholarlycommons.gbmc.org\/jchimp\/vol16\/iss4\/7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,7,17]]}},"URL":"https:\/\/doi.org\/10.55729\/2000-9666.1623","relation":{},"ISSN":["2000-9666"],"issn-type":[{"value":"2000-9666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}