5.3.4 Extensive TB disease

Extensive (or advanced) TB disease in adults is defined as the presence of bilateral cavitary disease or extensive parenchymal damage on chest radiography. In children aged below 15 years, extensive (or advanced) disease is usually defined by the presence of cavities or bilateral disease on chest radiography (see above regarding severe and nonsevere TB disease in children). This highlights the importance of chest radiography as part of the diagnostic work-up for patients, along with the usual patient–clinician interaction. Patients with extensive MDR/RR-TB disease should not be treated with the 9-month all-oral regimen with either linezolid or ethionamide because of the lack of evidence on the impact of this regimen in this subgroup of patients.

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