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Puzzling Clinical Appearance of a Pancreatic Tuberculosis Case

Anak Agung Fendy Tri Wicaksana1, Bramantono Bramantono, Musofa Rusli

  • 1Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. fendytri27@gmail.com.

Acta Medica Indonesiana
|November 2, 2023
PubMed

Insights

Pancreatic tuberculosis (TB) is a rare extrapulmonary infection. Diagnosis requires histopathology and bacteriology, but treatment with anti-tuberculosis therapy is effective for recovery.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Pathology

Background:

  • Tuberculosis (TB) commonly affects the lungs but can manifest in other organs as extrapulmonary TB.
  • Pancreatic TB is an exceptionally rare form, representing 0-4.7% of all TB cases globally.
  • Diagnosing pancreatic TB poses challenges due to its rarity and non-specific clinical presentation.

Observation:

  • A 71-year-old male presented with jaundice and weight loss.
  • Initial clinical evaluation, laboratory tests, tumor markers, and MRI scans were inconclusive.
  • Diagnosis was confirmed via histopathological examination revealing granulomas and positive Ziehl-Neelsen staining for Mycobacterium tuberculosis.

Findings:

  • The patient was treated with a 6-month course of Fixed Drug Combination (FDC) anti-tuberculosis therapy.
  • Following treatment, the patient experienced weight gain and improved serum bilirubin levels.
  • Abdominal CT scans showed no residual lesions post-treatment.

Implications:

  • This case highlights the importance of considering pancreatic TB in the differential diagnosis of unexplained jaundice and weight loss.
  • Histopathological and bacteriological confirmation are crucial for accurate diagnosis of rare pancreatic TB.
  • Successful treatment with standard anti-tuberculosis therapy demonstrates the efficacy of managing this rare extrapulmonary manifestation.
Keywords:
Anti-tuberculosis drugPancreatic tuberculosisZiehl Nelsengranuloma

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