[ON CLINICAL ASPECTS AND PATHOMORPHOLOGY OF ACUTE TUBERCULOUS SEPSIS].
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OBJECTIVE: The aim of this study is to describe the MRI features of focal splenic lesions in patients with disseminated tuberculosis. CONCLUSION: Tuberculous focal splenic lesions are small, multiple, and most often associated with splenomegaly. Signal intensities vary on both T1- and T2-weighted images. Two different enhancement patterns are noted: peripheral enhancement and gradual peripheral enhancement with complete fill-in.
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A case of jejunal tuberculosis causing isolated splenic vein thrombosis with natural shunt is reported, for the first time. The patient, presented with upper small bowel obstruction and massive upper gastrointestinal bleeding, was treated successfully with splenectomy, jejunal resection and antituberculous drugs.
A 48-year-old male had suffered from body weight loss and general malaise for 2 months. Abdominal computed tomography showed a dilated intrahepatic duct with stones and a hypodense nodular mass in the spleen. A splenectomy and distal pancreatectomy were performed under the preoperative impression of a malignancy. Histological examination of the specimens revealed tuberculosis.
Two cases of unusual extrapulmonary tuberculosis are presented. One patient was suffering of a pulmonary tuberculosis involving the brain, liver, spleen and peritoneum, with headaches, ascites, weight loss and night sweats. The other patient had lymph nodes and nodular liver tuberculosis and complained of fever, right upper quadrant pain, anorexia and weight loss. This tuberculosis form is extremely rare; only 23 cases were reported between 1950 and 1990. Furthermore, a drug-induced hepatitis developed in a liver already damaged by the tuberculosis and a chronic active C hepatitis. These two cases remind us that the diagnosis of extrapulmonary tuberculosis may be extremely difficult. It must be suspected mostly in patients that are immuno-depressed or whose origins are not caucasian. Other diagnoses are often wrongly suggested, such as tumors, inflammatory diseases or other infectious diseases. As a result, the correct diagnosis or other infectious diseases. As a result, the correct diagnosis is often delayed. If cultures are negative and the chest roentgenogram is normal, procedures such as transbronchial, liver, bone marrow or lymph node biopsies may help to properly identify the disease.
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