The reappearance of abdominal tuberculosis

Area of Science:

• Internal Medicine
• Infectious Diseases
• Gastroenterology

Background:

• Tuberculosis (TB) incidence is rising in urban settings, particularly among specific populations.
• Abdominal tuberculosis (ATB) presents diagnostic challenges, often mimicking other conditions.
• The human immunodeficiency virus (HIV) epidemic has been linked to increased TB prevalence.

Purpose of the Study:

• To describe the clinical characteristics, diagnostic methods, and treatment outcomes of abdominal tuberculosis.
• To identify key patient populations at higher risk for ATB.
• To emphasize the importance of suspecting ATB in at-risk individuals.

Main Methods:

• Retrospective chart review of 17 patients treated for abdominal tuberculosis.
• Analysis of presenting symptoms, physical findings, diagnostic imaging (CT scans), and diagnostic procedures (laparotomy, biopsies).
• Review of treatment regimens and patient responses to antituberculous chemotherapy.

Main Results:

• Common symptoms included abdominal pain, weight loss, and fever.
• Abdominal tenderness and pyrexia were frequent physical findings.
• Only 5 out of 17 patients had concurrent pulmonary tuberculosis.
• Computed tomography scans were valuable diagnostic aids.
• Diagnosis was established through various methods including laparotomy, endoscopic/percutaneous biopsy, and clinical/radiological evidence.
• All patients responded well to antituberculous chemotherapy.

Conclusions:

• Abdominal tuberculosis should be suspected in immigrants and patients with acquired immunodeficiency syndrome (AIDS) presenting with abdominal symptoms.
• Prompt diagnosis and appropriate antituberculous chemotherapy lead to favorable outcomes.
• Increased vigilance for ATB is warranted in urban areas due to the rising prevalence associated with HIV/AIDS.