Differences in patient profiles of abdominal and pulmonary tuberculosis: a comparative study

Tuberculosis remains a common infection and is often associated with non-specific constitutional symptoms or laboratory investigations regardless of site of manifestations. This study compares the profiles of abdominal tuberculosis (ATB) and pulmonary tuberculosis (PTB).

Patients with ATB (n=34, male-21, mean age 43.3 +/- 16.0 years) diagnosed over a nine year period were identified from the National Tuberculosis registry and retrospectively reviewed. Comparisons were made with patients treated for PTB (n=163).

The most commonly affected sites were the ileocecal regions, peritoneum and hepatobiliary system. Common clinical presentations were abdominal pain (61.8%), anorexia (44.1%), weight loss (55.9%), fever (41.1%) and abdominal distension (29.4%). Four patients had concomitant active PTB. Compared to PTB, patients with ATB had significantly lower serum haemoglobin (11.6 +/- 2.4 vs. 12.6 +/- 2.0 gm/dL, p=0.036) and higher rate of adverse events of antituberculous treatment (50% vs. 15.4%, p < 0.001). There were no difference in prevalence of constitutional symptoms (fever, weight loss and anorexia), platelet level, albumin, total protein and erythrocyte sedimentation rate. Importantly, there was no difference in the treatment response. More patients with ATB and concomitant active PTB had reported weight loss (100% versus 36.7%, p = 0.017).

There are differences in the profiles of ATB and PTB. Awareness of such differences can help to improve the understanding and management of this infection.