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At least 217 records · Page 12Linked to original sources
PubMed1994

[Duodenal tuberculosis. A rare cause of a covered perforation in the duodenal bulb].

Vague upper abdominal pain, weight loss (10 kg) and recurrent bouts of fever had been present for several months in a 77-year-old woman. Abdominal ultrasonography in the region of the head of the pancreas and duodenum had demonstrated several lymphomas, some of them with "air streaking". This finding suggested penetration from the duodenum to neighbouring lymph nodes. Plain film of the abdomen did not show free air, but at gastroscopy a covered perforation into the surrounding lymph nodes was found. At first lymphoma or Crohn's disease were considered in the differential diagnosis. But the finding of acid-fast bacteria in a biopsy from the pelvic crest suggested intestinal tuberculosis with dissemination. This diagnosis was confirmed by the direct demonstration of Mycobacterium tuberculosis in gastric juice. Under tuberculostatic treatment with daily 0.3 g isoniazid, 0.45 g rifampicin, 0.8 ethambutol and 1.5 g pyrazinamide, as well as 50 mg prednisolone to prevent stricture, the size of the tuberculous ulcer had markedly decreased within 2 weeks. Follow-up gastroscopy after 6 months showed almost complete healing without stricture. However rare, gastrointestinal tuberculosis should not be forgotten in the differential diagnosis because it can imitate a large variety of gastrointestinal diseases.

Aged↗
PubMed2000

Prevalence of tuberculosis in cattle in the Dangme-West district of Ghana, public health implications.

Bovine tuberculosis due to Mycobacterium bovis is a major cause of human gastrointestinal tuberculosis in developing countries where bovine milk is often not pasteurised before use. Little information is available on the prevalence of the disease in African cattle and its zoonotic impact. The Ghanaian Government, through its peri-urban dairy cattle development project, is promoting the use of milk and dairy products from local cows in selected districts of the country, including the Dangme-West district of the Greater Accra region. A survey was, therefore, undertaken to determine the prevalence of tuberculosis infection in cattle in this district and to assess the level of awareness with regard to the risks through milk consumption. The standard single intradermal comparative tuberculin test (SCITT) using purified protein derivative (PPD) of M. bovis and M. avium was used to detect cattle infected with M. bovis. The study established the prevalence of a 13.8% infection in cattle in the district although the prevalence was as high as 50% in some kraals. Prevalence was highest in the Ningo sub-district (19.0%), followed by Dodowa, the district capital (14.0%), while the other two sub-districts, Prampram and Osudoku had lower rates of 11.3 and 10. 8%, respectively. Cattle of all ages and both sexes were affected, but the prevalence in cows was twice as high as that in heifers or bulls. The study also established that there is a considerable lack of knowledge about bovine tuberculosis among cattle owners and herdsmen in the community and that milk is often used untreated, thus increasing the risk of human infection.

Age Factors↗
PubMed1994

[Extrapulmonary tuberculosis in childhood. Case reports from a pediatric specialty hospital].

The immigration of people from countries with high incidence of tuberculosis has led to an increased number of cases of tuberculosis in Austria. The number of cases of extrapulmonary tuberculosis has increased too. The variability of the clinical presentation of extrapulmonary tuberculosis which can affect almost every organ system makes it essential to include it in the differential diagnosis of any infectious disease. Early identification and rapid onset of therapy are most important for recovering without complications and avoidance of longterm sequelae. 9 cases of extrapulmonary tuberculosis in the Gottfried von Preyer Children's hospital from 1989 to 1992 show the different clinical features of this disease. 3 cases of tuberculous lymphadenitis, 1 case of tuberculosis of the adenoids, 1 case of tuberclulous pleurits, 3 cases of gastrointestinal tuberculosis and 1 case of a tuberculous meningitis and osteomyelitis are described. All 9 children recovered with antituberculous treatment without complications or sequelae.

Adolescent↗
PubMed1995

[Tactivin in combined treatment of patients with pulmonary tuberculosis associated with gastrointestinal diseases].

Tactivin was tried in combined therapy of 49 new-onset cases with destructive pulmonary tuberculosis and gastrointestinal lesions. 52 controls received antibacterial drugs alone. Tactivin increased T-lymphocyte count and improved their subpopulations proportion in a shorter period of time. Immunochemotherapy contributed to efficacy of the main and associated disease treatment. Healing of the destruction foci occurred in 87% versus 70% in controls, side effects of antibacterial drugs and exacerbations of gastrointestinal diseases arose 2-2.5 times less frequently.

Adjuvants, Immunologic↗
PubMed2006

Diagnostic value of Elisa serological tests in childhood tuberculosis.

Two separate studies (study I and study II) were conducted to evaluate the efficacy of ELISA serological test for the detection of IgG antibodies against specific glycolipid antigen (PGLTb1) and ESAT 6 antigen of Mycobacterium tuberculosis, respectively. These results were compared with bacteriological tests [Ziehl Neelson (ZN) staining for acid-fast bacilli and culture on Lowenstein Jensen (LJ) medium] and polymerase chain reaction (PCR) targeting IS6110 sequence. Both studies were carried out on children with pulmonary, central nervous system, lymph node, and gastrointestinal tuberculosis along with matching controls (65 cases and 27 controls for study I and 83 cases and 22 controls for study II). Informed consents of their parents or guardians were taken. They were subjected to clinical examination, relevant laboratory investigations, tuberculin test and chest radiograph. Relevant body fluids were subjected to bacteriological tests and PCR. Sera samples were analyzed for antibodies against PGLTbl and ESAT 6 antigen in study I and study II, respectively. ELISA tests showed a significantly higher sensitivity (49% study I; 53%, study II) as compared with LJ medium culture method (15.4%, study I; 28.9% study II) and ZN staining (27.7%, study I; 20.5%, study II) in all patients (p < 0.05). The results were comparable with PCR (40%, study I; 42.2% study II). Specificity of ELISA test was 100% in all the patients except in those with pulmonary disease (92.8%, study I; 84.8%, study II). In view of the convenience, low cost and comparable sensitivity with PCR, these ELISA tests have a promising future in the diagnosis of childhood tuberculosis.

Bacteriological Techniques↗
PubMed1998

Gastro-intestinal tuberculosis: an emerging diagnostic dilemma.

Nine cases of gastrointestinal tract tuberculosis seen by the author in 1995/96 are reported. In all the patients, the final diagnosis could only be established histologically. Pre-operative clinical examination and investigations had suggested otherwise. Six of these patients were HIV positive. This communication suggests that immunocompromised individuals are at increased risk of gastrointestinal tuberculosis. Clinicians, therefore, should bear in mind possible co-existence of gastrointestinal tract (GIT) tuberculosis and HIV when dealing with patients suffering from gastrointestinal tract diseases of unknown origin.

AIDS-Related Opportunistic Infections↗
PubMed1992

Extrapulmonary tuberculosis. A review.

The increase in cases of tuberculosis that has occurred with the increasing number of individuals infected with the human immunodeficiency virus (HIV) has focused attention on the problems in diagnosing and treating tuberculosis. While it is primarily considered a pulmonary disease, tuberculosis has the potential to infect almost every organ system via lymphohematogenous dissemination during the initial pulmonary infection. Since 1984 the incidence of extrapulmonary tuberculosis has increased at an even faster rate than that of pulmonary tuberculosis. Extrapulmonary tuberculosis is considered a diagnostic criterion in the case definition of the acquired immunodeficiency syndrome. Immunocompromised individuals, such as patients with HIV, are at increased risk for extrapulmonary tuberculosis. The clinical manifestations are often nonspecific and insidious, and diagnosis may be delayed for years. Cases of miliary and meningeal tuberculosis are an exception, and they often constitute medical emergencies. Tuberculosis skin tests should be performed on all individuals suspected of having tuberculosis, but a negative test result does not exclude the diagnosis. Chest roentgenograms will often show signs of old or active pulmonary tuberculosis. Microscopic examination and culture of infected body fluids and/or tissue are necessary for definitive diagnosis. Treatment is with standard antituberculous medications. Short-course therapy (6 or 9 months) is probably adequate in most patients with extrapulmonary tuberculosis, but patients with human immunodeficiency viral infection need longer treatment. Extrapulmonary tuberculosis is a persistent problem in the United States and will become more prevalent as the number of patients with HIV increases. A high index of suspicion is needed to diagnose and treat extrapulmonary tuberculosis in a timely and health-preserving manner.

Female↗
PubMed1975

Abdominal tuberculosis: demonstration of tubercle bacilli in tissues and experimental production of hyperplastic enteric lesions.

Material obtained from 35 cases of abdominal tuberculosis waps studied and an attempt was made to demonstrate tubercle bacilli by special staining of histological sections, culture and guinea-pig inoculation. Acid fast bacilli could be demonstrated in 80 per cent of cases. The remaining cases were also possibly due to tuberculous infection because granulomas with Langhans's type of giant cells and caseation or calcification of lymph nodes were present. The bacilli were demonstrated in bowel tissue showing non-specific histology in 1 case. In 2 other cases with non-specific lesions in the bowel the bacilli were demonstrated in lymph nodes. Guinea-pig inoculation studies showed that hypertrophic lesions of the bowel with a non-specific type of reaction could develop after intraperitoneal injection of tubercular material. Although it cannot be said on the basis of this study that Crohn's disease is caused by tuberculous infection, it can be concluded that tuberculous infection can give rise to a Crohn's type of lesion.

Animals↗
PubMed1976

Clinical diagnosis of abdominal tuberculosis.

One hundred and eighty-two cases of abdominal tuberculosis admitted to Swaroop Rani Nehri (SRN) Hospital, Allahabad, in the past 7 years have been reviewed. The clinical diagnosis of abdominal tuberculosis was made correctly only in 50 per cent of cases. About half the cases presented with chronic or acute on chronic intestinal obstruction. The remaining patients had vague pains, tender abdomen, constitutional symptoms or a mass in the abdomen. Diarrhoea was not frequent and fistula formation was rare. A chronic obstructive type of lesion was found not only in cases with a bowel lesion but also in patients with chronic miliary peritonitis and tuberculous mesenteric adenitis. Similarly, a lump was present not only in hypertrophic bowel tuberculosis but also in chronic miliary peritonitis and tuberculous mesenteric adenitis. On radiological examination false positive features such as fluid levels, bowel dilatation or even the 'string' sign were encountered. Liver and endometrial biopsies were positive in only a very few cases. Peritoneal biopsy was of considerable help, being positive in 88 per cent of ascitic cases and in 42-1 per cent of non-ascitic cases. Open peritoneal biopsy obtained after making a small incision in the right iliac fossa was found to be the most useful investigation in the diagnosis of abdominal tuberculosis. An ascitic fluid protein content of 2-5 g or more and a predominantly lymphocytic count of over 100/mm3 are diagnostic, but a cell count of 10/mm3 was recorded in one tuberculous case.

Abdomen↗
PubMed1980

Abdominal tuberculosis.

In Britain abdominal tuberculosis is an uncommon condition and most cases come to laparotomy for diagnosis. A high index of suspicion is required in areas with a large immigrant population and in areas which are overcrowded and nutritionally deprived. Nine of 28 patients presented acutely and a wide variety of preoperative diagnoses were entertained. Most of the remainder had a long history of vague constitutional symptoms and laparotomy was required for diagnosis in all but 5. Histology proved the surest way of establishing the diagnosis.

Abdomen, Acute↗
PubMed1992

Trend of large bowel tuberculosis and the relation with pulmonary tuberculosis.

From 1965 to 1989, 60 cases of large bowel tuberculosis among 116 cases of abdominal tuberculosis are reviewed and analyzed. Lesions located in the cecum or ileocecal region were found in 49 of the 60 cases. Most of the patients (50/60) received surgical intervention, but the definite diagnoses had never been proved until surgery. The diagnoses were proved by histopathologic examination in these 50 cases. Antituberculosis medications were given for at least nine months in all patients. Twenty-nine of the 50 patients who received operations had primary anastomosis during the operations, and no leakage occurred. Evidence of pulmonary tuberculous lesions could be found in 40 of the 60 cases. Positive findings of tubercle bacilli in sputum smear or culture were noted in 13 cases. The positive rate of sputum examinations decreased during 1980 to 1989; 25.6 percent (10/39) were positive from 1965 to 1979 and 14 percent (3/21) were positive from 1980 to 1989. In the meantime, there was a steady decline in the cases of large bowel tuberculosis in the most recent few years. An antituberculosis program has been carried out in the past 40 years with remarkable effect in the Taiwan area, but the possibility of intestinal tuberculosis still exists. The authors suggest that surgeons keep tuberculosis in mind when they are dealing with patients who suffer from intestinal obstruction of unknown origin with the suspected findings of pulmonary tuberculosis in chest x-ray films.

Adolescent↗