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Abdominal Tuberculosis in Children: A Diagnostic Challenge
- Source :
- Journal of Microbiology, Immunology and Infection. 43:188-193
- Publication Year :
- 2010
- Publisher :
- Elsevier BV, 2010.
-
Abstract
- Background/Purpose Abdominal tuberculosis (TB) is a rare manifestation of childhood TB. Abdominal TB is characterized by long-lasting abdominal symptoms, which are usually confused with other conditions, and the diagnosis is usually delayed. Methods During a 5-year period, we identified 10 cases of abdominal TB in a tertiary care children's hospital. Data including demographic characteristics, presenting symptoms, history of Bacille Calmette-Guerin vaccination, lesion sites, laboratory data, image findings, diagnosis, tuberculin skin test, risk factors, treatment, and outcome were collected and analyzed. Results There were six female patients and four male patients, with a mean age of 14.7 years. One patient died due to the complication of disseminated TB with a pneumothorax. Household members with TB could be traced in six (60%) patients. The most common clinical presentations included fever (9/10), abdominal pain (8/10), and weight loss (8/9). The diagnosis of abdominal TB was suspected initially in only three patients; the others were not diagnosed until 7–36 days (mean=19 days) after hospitalization. The abnormal abdominal image findings, by either computed tomography or ultrasound, included lymphadenopathy (7/9), high-density ascites (6/9), thickening of the omentum or peritoneum (6/9), inflammatory mass (3/9), bowel wall thickening (1/9), and liver abscess (1/9). The chest radiography was abnormal in nine patients. Mycobacterium tuberculosis was isolated from ascites in two out of four patients, gastric aspirates in three, sputum in three, and intra-abdominal tissue specimens in two. Laparotomy was performed in three patients, laparoscopy in one, and colonoscopy in one. Conclusion In Taiwan, abdominal TB should be considered in patients with fever, abdominal pain, weight loss, and abnormal chest radiography. Characteristic computed tomography findings of abdominal TB and a history of exposure to TB contribute to the diagnosis.
- Subjects :
- Male
Microbiology (medical)
medicine.medical_specialty
Abdominal pain
Tomography Scanners, X-Ray Computed
Tuberculosis
Adolescent
medicine.medical_treatment
Peritonitis, Tuberculous
Taiwan
Peritonitis
Colonoscopy
Tuberculosis, Lymph Node
Diagnosis, Differential
children
Immunology and Microbiology(all)
Laparotomy
Abdomen
medicine
Humans
Immunology and Allergy
Child
abdominal tuberculosis
General Immunology and Microbiology
medicine.diagnostic_test
business.industry
computed tomography
Mycobacterium tuberculosis
General Medicine
medicine.disease
Surgery
Treatment Outcome
Infectious Diseases
medicine.anatomical_structure
Tuberculosis, Gastrointestinal
Pneumothorax
Child, Preschool
Female
Radiology
medicine.symptom
business
Liver abscess
Subjects
Details
- ISSN :
- 16841182
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Journal of Microbiology, Immunology and Infection
- Accession number :
- edsair.doi.dedup.....cd7a8be46691a7d4ebaf015bc8c2fb9a