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[Extrapulmonary tuberculosis: 2 cases with hepatic, splenic, peritoneal and cerebral involvement]
Revue Medicale De La Suisse Romande
|May 1, 1996
Summary
Diagnosing extrapulmonary tuberculosis (EPTB) is challenging, often requiring biopsies for confirmation. Early suspicion in immunocompromised individuals is crucial for timely treatment.
Area of Science:
- Medicine
- Infectious Diseases
- Pulmonology
Background:
- Extrapulmonary tuberculosis (EPTB) is a rare form of tuberculosis affecting organs outside the lungs.
- This condition presents diagnostic challenges, often mimicking other diseases.
Observation:
- Two cases of unusual EPTB are presented, involving the brain, liver, spleen, peritoneum, and lymph nodes.
- One patient developed drug-induced hepatitis on a background of liver tuberculosis and chronic hepatitis C.
- Symptoms included headaches, ascites, weight loss, night sweats, fever, and right upper quadrant pain.
Findings:
- EPTB diagnosis can be difficult, with only 23 reported cases between 1950 and 1990.
- Diagnosis is often delayed due to non-specific symptoms and initial misdiagnosis as tumors, inflammatory, or other infectious diseases.
- Biopsies (transbronchial, liver, bone marrow, lymph node) are vital when cultures are negative and chest X-rays are normal.
Implications:
- Increased suspicion for EPTB is warranted in immunocompromised patients and individuals of non-Caucasian origin.
- Prompt and accurate diagnosis of EPTB is essential to prevent severe complications and ensure effective treatment.
- Diagnostic strategies should include invasive procedures when initial investigations are inconclusive.