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[Abdominal tuberculosis and amebic abscess. Simultaneous diagnosis of 2 rare infections of same localization]
G Myklebust1, J Barstad, K Brabrand
1Medisinsk avdeling, Sentralsykehuset i Akershus, Nordbyhagen.
Abstract:
A 26-year-old Indian male was admitted to hospital with loss of weight and vague abdominal pain of several weeks duration. Ultrasonography and computed tomography showed several expansive lesions near the pancreatic head, probably representing enlarged lymph nodes. A few milliliters of yellowish pus were aspirated by ultrasound guided aspiration. Microscopic examination of the pus showed trophozoits, and Mycobacterium tuberculosis subsequently grew from the pus culture. Abdominal tuberculosis is a rare condition, particularly in the pancreas and the peripancreatic region. The report stresses the importance of considering the possible coexistence of more than one infectious disease in patients from endemic areas.
Insights
Tuberculosis rarely affects the pancreas. This case highlights Mycobacterium tuberculosis infection presenting as abdominal lymphadenopathy in a young Indian male, emphasizing the need for broad infectious disease screening.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Abdominal tuberculosis is uncommon, especially involving the pancreas and surrounding lymph nodes.
- Early diagnosis can be challenging due to vague symptoms and non-specific imaging findings.
Observation:
- A 26-year-old male presented with weight loss and abdominal pain.
- Imaging revealed pancreatic head lesions suggestive of enlarged lymph nodes.
- Ultrasound-guided aspiration yielded pus containing trophozoites, with Mycobacterium tuberculosis identified on culture.
Findings:
- The patient was diagnosed with abdominal tuberculosis affecting the peripancreatic region.
- Microscopic examination and culture confirmed Mycobacterium tuberculosis as the causative agent.
Implications:
- This case underscores the importance of considering tuberculosis in the differential diagnosis of pancreatic head masses, particularly in endemic regions.
- Clinicians should maintain a high index of suspicion for concurrent infections in patients presenting with complex abdominal pathologies.