Mycobacterium tuberculosis dissemination plays a critical role in pathogenesis

Madeleine G. Moule*, Jeffrey D. Cirillo

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Mycobacterium tuberculosis is primarily a respiratory pathogen. However, 15% of infections worldwide occur at extrapulmonary sites causing additional complications for diagnosis and treatment of the disease. In addition, dissemination of M. tuberculosis out of the lungs is thought to be more than just a rare event leading to extrapulmonary tuberculosis, but rather a prerequisite step that occurs during all infections, producing secondary lesions that can become latent or productive. In this review we will cover the clinical range of extrapulmonary infections and the process of dissemination including evidence from both historical medical literature and animal experiments for dissemination and subsequent reseeding of the lungs through the lymphatic and circulatory systems. While the mechanisms of M. tuberculosis dissemination are not fully understood, we will discuss the various models that have been proposed to address how this process may occur and summarize the bacterial virulence factors that facilitate M. tuberculosis dissemination.

Original languageEnglish
Article number65
JournalFrontiers in Cellular and Infection Microbiology
Publication statusPublished - 25 Feb 2020


  • dissemination
  • extrapulmonary
  • Mycobacterium
  • pathogenesis
  • tuberculosis


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