Tuberculosis (TB) remains a major global public health problem worldwide. Though Pulmonary TB (PTB) is mostly discussed, one in five cases of TB present are extrapulmonary TB (EPTB) that manifests conspicuous diagnostic and management challenges with respect to the site of infection. The diagnosis of EPTB is often delayed or even missed due to insidious clinical presentation, pauci-bacillary nature of the disease, and lack of laboratory facilities in the resource limited settings. Culture, the classical gold standard for the diagnosis of tuberculosis, suffers from increased technical and logistical constraints in EPTB cases. Other than culture, several other tests are available but their feasibility and effciacy for the detection of EPTB is still the matter of interest. We need more specific and precise test/s for the various forms of EPTB diagnosis which can easily be applied in the routine TB control program is required. A test that can contribute remarkably towards improving EPTB case detection reducing the morbidity and mortality is the utmost requirement. In this review we described the scenario of molecular and other noval methods available for laboratory diagnosis of EPTB, and also discussed the challenges linked with each diagnostic method. This review will make the readers aware of new emerging diagnostic techniques in the field of EPTB diagnosis. They can make an informed decision to choose the appropriate one according to the test availability, their clinical settings and financial considerations.

中文翻译：

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肺外结核的诊断：新诊断方法的更新

结核病（TB）仍然是全球主要的公共卫生问题。尽管人们主要讨论肺结核（PTB），但五分之一的结核病例是肺外结核（EPTB），其在感染部位方面表现出明显的诊断和管理挑战。由于隐匿的临床表现、该疾病的寡杆菌性质以及在资源有限的环境中缺乏实验室设施，EPTB 的诊断经常被延迟甚至漏诊。培养是诊断结核病的经典金标准，但在 EPTB 病例中受到越来越多的技术和后勤限制。除了培养之外，还有其他几种检测方法，但它们检测 EPTB 的可行性和有效性仍然令人感兴趣。我们需要针对各种形式的 EPTB 诊断进行更具体、更精确的测试，这些测试可以轻松应用于常规结核病控制计划。最重要的要求是能够显着改善 EPTB 病例检测、降低发病率和死亡率的检测。在这篇综述中，我们描述了可用于 EPTB 实验室诊断的分子和其他新方法的情况，并讨论了与每种诊断方法相关的挑战。本综述将使读者了解 EPTB 诊断领域新兴的诊断技术。他们可以根据测试的可用性、临床环境和财务考虑因素做出明智的决定，选择合适的测试。