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At least 55 records · Page 3Linked to original sources
PubMed1984

A case of tuberculous epididymitis associated with Addison's disease.

A 68-year-old man was admitted to the hospital because of loss of appetite, easy fatigability, and skin pigmentation. Physical examination revealed that the bilateral epididymides were enlarged and hard without tenderness. At 7 a.m., the basal cortisol level in the plasma was 22.4 ng/ml and ACTH 318 pg/ml. The clinical diagnosis was Addison's disease. Biopsy of the right epididymis revealed evidence of active tuberculosis. Hydrocortisone (18 mg/day) and anti-tuberculous drugs were administered, and the patient became well and regained his appetite in a week. In this case, laparotomy was not performed, but all clinical findings and the course indicated that adrenal tuberculosis was the most likely cause of Addison's disease. CT scanning of the adrenal region demonstrated large, bilateral, homogeneous, low density, and non-enhancing mass. This is the first report dealing with CT findings of Addison's disease with tuberculous epididymitis.

Addison Disease↗
PubMed1990

Tuberculous thyroiditis and miliary tuberculosis manifested postpartum in a patient with thyroid carcinoma.

Right nodular goiter with diffuse miliary shadow on chest roentgenogram was found in a postpartum febrile woman. Transbronchial lung biopsy revealed tuberculous granuloma and acid-fast bacilli were found by aspiration cytology of the thyroid. Although chemotherapy was effective, the thyroid nodule remained palpable and the serum thyroglobulin level remained high. Subtotal thyroidectomy revealed papillary carcinoma associated with tuberculosis and lymph nodes metastasis. This seems to be the first case report of a patient with tuberculous thyroiditis, coexisting with thyroid carcinoma, diagnosed by aspiration cytology and treated prior to surgery.

Adult↗
PubMed2003

Tuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: experience from China.

AIM: To determine the clinical, radiographic and laboratory characteristics, diagnostic methods, and therapeutic variables in immunocompetent patients with tuberculosis (TB) of the pancreas and peripancreatic lymph nodes. METHODS: The records of 16 patients (6 male, 10 female; mean age 37 years, range 18-56 years) with tuberculosis of the pancreas and peripancreatic lymph nodes from 1983 to 2001 in the Southwest Hospital were analyzed retrospectively. In addition, 58 similar cases published in Chinese literature were reviewed and summarized. We reviewed the clinical, radiographic and laboratory findings, diagnostic methods, therapeutic approaches, and outcome in the patients. Criteria for the diagnosis of pancreatic tuberculosis were the presence of granuloma in histological sections or the presence of Mycobacterium tuberculosis DNA by polymerase chain reaction (PCR). RESULTS: Predominant symptoms consisted of abdominal nodule and pain (75 %), anorexia/weight loss (69 %), malaise/weakness (64 %), fever and night sweats (50 %), back pain (38 %) and jaundice (31 %). Swelling of the head of the pancreas with heterogeneous attenuation echo was detected with ultrasound in 75 % (12/16). CT scan showed pancreatic mass with heterogeneous hypodensity focus in all patients, with calcification in 56 % (9/16) patients, and peripancreatic nodules in 38 % (6/16) patients. Anemia and lymphocytopenia were seen in 50 % (8/16) patients, and pancytopenia occurred in 13 % (2/16) patients. Hypertransaminasemia, elevated alkaline phosphatase (AP) and GGT were seen in 56 % (9/16) patients. The erythrocyte sedimentation rate (ESR) was elevated in 69 % (11/16) cases. Granulomas were found in 75 % (12/16) cases, and in 38 % (6/16) cases caseous necrosis tissue was found. Laparotomy was performed in 75 % (12/16) cases, and ultrasound-guided fine needle aspiration (FNA) was done in 63 % (10 of 16). The most commonly used combinations of medications were isoniazid/rifampin/streptomycin (63 %, n=10) and isoniazid/rifampin pyrazinamide/streptomycin or ethambutol (38 %, n=6). The duration of treatment lasted for half or one year and treatment was successful in all cases. The characteristics of 58 cases from Chinese literature were also summarized. CONCLUSION: Tuberculosis of the pancreas and peripancreatic lymph nodes should be considered as a diagnostic possibility in patients presenting with a pancreatic mass, and diagnosis without laparotomy is possible if only doctors are aware of its clinical features and investigate it with appropriate modalities. Pancreatic tuberculosis can be effectively cured by antituberculous drugs.

Adult↗
PubMed1999

Disseminated tuberculosis: still a diagnostic challenge.

Disseminated tuberculosis is notoriously difficult to diagnose and, with the decrease in tuberculosis incidence in Australia, familiarity with its manifestations has dwindled. We describe four bacteriologically proven cases which illustrate the range of presentations and diagnostic difficulties. Surprisingly, immunosuppressive therapy need not cause rapid deterioration. Disseminated tuberculosis should be considered in any patient with multisystem illness who is at risk of tuberculosis, particularly if born overseas. In the absence of confirmatory results, a prompt therapeutic trial may be life-saving.

Adult↗
PubMed1989

[Morphology and endocrinology of a fatal course of Addison crisis].

A 36 year-old man fell ill with violent dorsalgia seemingly related to spondylosis. The diagnosis of tuberculous spondylitis was made as late as 18 months after the onset of symptoms. The disease rapidly progressed to death in spite of adequate tuberculostatic and surgical therapy. The post-mortem examination revealed a massively caseating tuberculosis of both adrenal glands suggestive of Addison's disease. Severe adrenocortical insufficiency was confirmed by low steroid hormone levels in the post-mortem blood; the validity of these results is indicated by comparative hormone level determinations in a series of recent and stored post-mortem blood specimens.

Addison Disease↗
PubMed1987

[Genital tuberculosis in a 14-year-old girl].

The authors report the case of a 14 year-old girl presenting with pulmonary, adrenal and genital tuberculosis. Pelvic pain was the presenting symptom. Association of familial contamination, phlyctenular Mantoux test, apex infiltrate with a calcified nodule on chest x-ray film and numerous pelvic calcifications on plain films of the abdomen led to diagnosis. The authors emphasize the importance of the supervision of Mantoux test and the necessity of treatment of any latent primary tuberculosis.

Adolescent↗