胃肠道结核病的不常见表现-A病例系列
Sapna Dixit1, Ajay Kumar Verma1, Jyoti Bajpai1
1Department of Respiratory Medicine, King George's Medical University, Lucknow, India.
The Indian journal of tuberculosis
|January 31, 2025
概括
肺外结核 (EPTB) 很少见,特别是在胰腺和胆囊中. 这一案例系列突出了印度的各种腹部EPTB表现,强调了流行地区的诊断谨慎性.
科学领域:
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
- 病理学 病理学 病理学
背景情况:
- 结核病 (TB) 不成比例地影响欠发达国家,印度报告了全球28%的病例.
- 肺结核是最常见的,但肺外结核 (EPTB) 呈现的变化很大,可以模仿其他疾病.
- EPTB在免疫功能低下的个体中更为普遍,特别是艾滋病毒感染者,占艾滋病毒阳性个体新结核病例的40-50%.
研究的目的:
- 报告一个涉及胰腺,胆囊和脏的腹部EPTB病例系列.
- 强调EPTB的非特异性和可变呈现所带来的诊断挑战.
- 突出EPTB在流行地区的高度怀疑的重要性,特别是在免疫功能低下的患者中.
主要方法:
- 病例系列报告了患有腹部EPTB的患者.
- 通过组织病理学检查 (HPE) 和酸快细菌 (AFB) 涂抹证实了诊断.
- 治疗包括6个月的标准抗结核疗法 (ATT).
主要成果:
- 淋巴结核结核是印度最常见的EPTB (35%的EPTB病例).
- 结核病发病率为8%;胰腺和胆囊结核病非常罕见.
- 该病例系列侧重于结核病的罕见腹部表现.
结论:
- 腹部EPTB,特别是涉及胰腺和胆囊,呈现非特异性症状,使诊断复杂化.
- 高可疑指数和适当的诊断方法 (HPE,AFB涂抹) 对于及时诊断EPTB至关重要.
- 迅速的ATT治疗对于管理EPTB病例至关重要.
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