Abdominal tuberculosis: a retrospective review of cases presenting to a UK district hospital
| Autor: | S. O. Brij, David A Enoch, J P Mamo |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Diarrhea Male medicine.medical_specialty Abdominal pain Tuberculosis Fever Antitubercular Agents Peritonitis Tuberculous Peritonitis Young Adult Internal medicine Weight Loss Tuberculosis Hepatic medicine Humans Aged Retrospective Studies business.industry Isoniazid Retrospective cohort study General Medicine Middle Aged Pyrazinamide Hospitals District medicine.disease Abdominal Pain Surgery Treatment Outcome medicine.anatomical_structure England Tuberculosis Gastrointestinal Abdomen Female medicine.symptom business medicine.drug |
| Zdroj: | QJM. 106:347-354 |
| ISSN: | 1460-2393 1460-2725 |
| DOI: | 10.1093/qjmed/hct003 |
| Popis: | Introduction: Peterborough has one of the highest rates of tuberculosis in the East of England; ∼40% of TB treated locally is extra-pulmonary. Aim and methods: All adults diagnosed with abdominal tuberculosis (ATB) between January 2008 and September 2011 in Peterborough Hospitals were retrospectively evaluated with regard to their clinical history, investigation, management and outcomes. Results: In total, 17 patients diagnosed with ATB were reviewed. All the patients were from (or descended from) high-risk ethnic groups. Four had co-existing pulmonary TB. Intestinal and peritoneal TB were the most common findings. The most common clinical manifestations included abdominal pain (71%), weight loss (59%), diarrhoea (47%) and pyrexia (41%). Fifteen patients had samples sent for microbiological investigation; 1 (6%) was smear positive and 9 (53%) were culture positive. Two (12%) were isoniazid resistant. No rifampicin resistance was detected. Anti-tuberculous therapy was given for 6–12 months. In total, 16 (94%) patients completed the treatment; 1 patient died prior to regime completion (crude mortality: 6%). There was one reported case of pyrazinamide intolerance and two episodes of isoniazid intolerance. Discussion: ATB is a diagnostic challenge, especially in absence of lung involvement. It mimics other diseases and clinical presentation is usually non-specific, which may lead to diagnostic delay and development of complications. Extreme vigilance should be used when dealing with unexplained abdominal symptoms to ensure timely diagnosis of ATB. Early diagnosis with early anti-tuberculous therapy and surgical treatment are essential to ensure as positive an outcome as possible. |
| Databáze: | OpenAIRE |
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