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PubMed1990

Primary macronodular hepatic tuberculosis: US and CT appearances.

Tuberculosis of the liver is uncommon except in association with miliary dissemination. Although hepatic involvement by tuberculosis tends to be diffuse, the macronodular or pseudotumor forms are rare. In addition, reports of actual imaging of tuberculous liver involvement are rare. A 5-year-old boy with a febrile illness due to macronodular hepatic tuberculosis, demonstrated by abdominal computed tomography (CT), and diagnosed by liver biopsy is presented.

Child, Preschool↗
PubMed2006

[Imaging of pancreatic and hepatic tuberculosis in an infant presenting with jaundice].

The incidence of abdominal tuberculosis has increased over the last decade and can mimic any other disease. Pancreatic involvement is an uncommon cause of jaundice in children. A case of obstructive jaundice due to pancreatic tuberculosis in an infant, with hepatic involvement is reported. The sonographic and computed-tomographic features are described.

Child↗
PubMed2000

Miliary hepatic tuberculosis not associated with splenic or lung involvement. A case report.

Miliary hepatic involvement is a frequent finding on autopsy in patients with disseminated tuberculosis. Imaging studies may reveal hepatosplenomegaly and/or parenchymal inhomogeneity and, in a minority of cases, focal lesions, invariably associated with miliary lung disease. An unusual case of disseminated tuberculosis with manifestations of miliary hepatic involvement, abdominal and neck lymphadenopathy on US and CT without any evidence of active disease in the lungs, spleen or other organ, is described.

Abdomen↗
PubMed1991

[Pseudotumoral hepatic tuberculosis].

Liver infection as a result of tuberculosis is well known; there are several histological lesions, the most important being epithelioid cell granuloma. There are 3 anatomo-clinic variants: military or micronodular type, macronodular or pseudotumoral and pericanalicular of cholestatic. A case of a 66 year old male with a diagnosis of hepatic pseudotumoral tuberculosis, confirmed by means of a laparoscopy, is presented. The rareness of this particular presentation is discussed, as well as the difficult diagnosis due to confusion with primary or metastatic tumors of the liver.

Aged↗
PubMed1988

Atypical hepatic tuberculosis presenting as obstructive jaundice.

A 78-yr-old female with a short history of malaise, anorexia, mild pyrexia, and obstructive jaundice is presented. A diagnosis of tuberculosis of the liver and gallbladder was established at laparotomy. In spite of anti-tuberculous therapy, the patient died on the 5th postoperative day. Widespread miliary tuberculosis affecting the lung, kidneys, spleen, and mesenteric lymph nodes was observed in postmortem studies, with strikingly severe involvement of the intrahepatic bile ducts. Saccular dilatation of the bile ducts alternating with areas of stenosis and narrowed intrahepatic bile ducts was seen. A correlation of the radiological and hepatic postmortem findings is discussed. The atypical presentation of tuberculosis in present times and the causes of jaundice in atypical cases of hepatic tuberculosis are discussed. The rarity of gallbladder tuberculosis is pointed out.

Aged↗
PubMed2002

Hepatic tuberculosis--a case report.

Though abdominal tuberculosis is fairly common in our country, incidence of tuberculous hepatitis is rare. The authors reported a case who presented to the surgical OPD of the NRS Medical College, Calcutta with complaints of right upper quadrant abdominal pain, flatulent dyspepsia, nausea and occasional vomiting. Ultrasonography (USG) revealed fibrotic gall bladder without any calculus suggesting chronic acalculus cholecystitis. On exploration of the abdomen, the gall bladder was found to be fibrotic and thickened without any calculus. Multiple scarred nodules of different sizes were found in the liver. Cholecystectomy was done and a scarring nodule from the liver was taken for histopathological examination which revealed a tuberculous granuloma. Histopathology of the gall bladder showed cholesterosis. The patient responded to antituberculous drugs.

Antitubercular Agents↗
PubMed1976

Spleno-hepatic tuberculosis due to Mycobacterium kansasii.

A case of tuberculosis of the spleen and liver is described. The organism involved was Mycobacterium kansasii, one of the atypical mycobacteria. The lack of evidence in the literature of primary splenic or hepatic involvement by this organism suggests that it is rare. In this instance it complicated a case of myeloproliferative disease, megakaryocytic myelosis with extra-medullary haemopoiesis, and was not diagnosed until autopsy.

Autopsy↗
PubMed2003

The nodular form of hepatic tuberculosis: a review with five additional new cases.

BACKGROUND: Tuberculosis presenting as an isolated liver tumour, without active pulmonary or miliary tuberculosis, or other clinical evidence of tuberculosis, is distinctly rare. A greater awareness of this rare clinical entity may prevent needless surgical intervention. AIMS: To help characterise this distinctly rare presentation of tuberculosis, five new cases are presented, together with a review of the world literature. The clinical, laboratory, radiological, and pathological features of these patients are described. METHODS: Polymerase chain reaction (PCR) assay of the liver tissue was carried out in all cases to confirm an aetiological diagnosis of Mycobacterium tuberculosis infection. RESULTS: All five patients (44-71 years old; two women, three men) underwent surgery, and had a preoperative diagnosis of malignant hepatic neoplasm and a postoperative histological diagnosis of chronic granulomatous inflammation, suggestive of tuberculosis. None of them had a known previous history of tuberculosis. All of them were positive for M tuberculosis by PCR analysis of the liver tissue. CONCLUSIONS: This report illustrates the difficulty in reaching a correct preoperative diagnosis. It is usually unsuspected and confused with primary or metastatic carcinoma of the liver, especially when it coexists with other malignancies. A high index of suspicion is required for diagnosis, which can be made only by histological and bacteriological studies, and PCR analysis.

Adult↗
PubMed2004

Isolated hepatic tuberculosis in a transplanted liver.

BACKGROUND: The incidence of tuberculosis (TB) has been increasing, especially in immunocompromised patients. It was reported that the overall incidence of TB in solid-organ transplant recipients is 0.8%. Hepatic graft TB was reported once before in a child, who underwent living-related hepatic graft transplantation. CASE REPORT: A 43-year-old man underwent orthotropic liver transplantation (OLT) in October 1999. His pre-transplant work-up was negative for TB (history and PPD skin test). He developed an episode of acute rejection which responded to steroids. He was discharged home on December 1999 with normal liver function tests (LFT). His LFT remained normal during January 2000, but his serum transaminases were found elevated on February 2000 (aspartate aminotransferase [AST] 206, alanine aminotransferase [ALT] 266). A liver biopsy then showed no evidence of TB or cytomegalovirus disease. The patient continued to have stable elevation of his serum AST and ALT until late March 2000 when a repeat liver biopsy showed caseating granuloma. The patient was started on anti-TB medications, with which he was compliant. By mid-May 2000 he was doing well, with significant reduction in his transaminase levels (AST 72, ALT 79). A retrospective inquiry about the donor revealed that he was a healthy young man from India, who died in a road traffic accident. CONCLUSION: To our knowledge our patient appears to be the first case reported of isolated hepatic TB in the OLT patient population. It is likely that the allograft was infected prior to transplantation and the disease was reactivated nearly 3 months after the procedure.

Adult↗
PubMed1997

[Hepatic tuberculosis].

Tuberculosis of the liver can be the only manifestation of the disease or it may be a part of disseminated process. Three cases of liver tuberculosis were presented. In one of them the process was restricted to the liver and the diagnosis was made only at autopsy. In two other cases, tuberculosis of the liver was a part of disseminated process. In one of them the impairment of liver function improved after therapy and in another one, in spite of therapy, the patient died with signs of cardio-respiratory and hepatic insufficiency.

Adult↗
PubMed2006

[Pseudo-tumoral hepatic tuberculosis developing into a multinodular form despite treatment].

Localized macronodular tuberculosis of the liver is rare. In this location antituberculosis therapy results in a favorable clinical evolution in 100% of cases. We report a pseudo-tumoral form of this condition with no specific clinical, biological or radiological data. After ultrasound guided needle aspiration cytology suggesting metastasis, the correct diagnosis was obtained on liver biopsy after laparotomy. After what was probably inadequate therapy, the enlargement of several hepatic and splenic macronodules was observed. After two years and eight months, the clinical condition of the patient was good but radiological features remained. The risk of diagnostic errors and the therapeutic difficulties in the zones where the incidence of tuberculosis is low should be noted.

Antitubercular Agents↗
PubMed1990

Prepare for the 1990s: Part I. Update: tuberculosis, hepatitis and acquired immunodeficiency syndrome.

To properly care for patients, gastroenterology nurses and associates need current information for safe and effective infection control. It is important to understand the infections that potentially could be transmitted in the GI unit. Knowledge is needed for the preparation and care of equipment to minimize transmission of infectious agents. Health care providers responsible for the disinfection of endoscopic equipment must know which infectious and chemical cleaning agents threaten them. This column will attempt to cover these areas during the coming year.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Recurrent Salmonella enteritidis sepsis and hepatic tuberculosis.

A 33 year old woman with recurrent Salmonella enteritidis sepsis is described. Penicillins, ceftriaxone, ciprofloxacin, and chloramphenicol could not eradicate the salmonellas but a combination of high dose ciprofloxacin and ceftriaxone for the eighth episode successfully cured the infection. The combination of ciprofloxacin and ceftriaxone may be a valuable therapeutic regimen in patients with recurrent salmonella sepsis. Prolonged intrahepatic cholestasis resulting from granulomatous hepatitis in this patient improved considerably with empiric ursodeoxycholic acid treatment. A liver biopsy specimen showing non-caseating epitheloid granulomas was positive for mycobacterial DNA by polymerase chain reaction. Repeated bronchoscopy with multiple biopsies eventually revealed caseating granulomas with acid fast bacilli in the lung biopsy specimens. Therefore, tuberculosis was diagnosed as the underlying disease and the cause of granulomatous hepatitis in this patient and tuberculostatic treatment was started. Polymerase chain reaction for mycobacterial DNA may be helpful in the differential diagnosis of hepatic granulomas when routine histological examination and culture of biopsy specimens are not diagnostic. Tuberculosis should be considered as one of the diseases predisposing to recurrent salmonella sepsis.

Adult↗
PubMed1976

Incidence of tuberculosis, hepatitis, brucellosis, and shigellosis in British medical laboratory workers.

A retrospective postal survey of 21 000 medical laboratory workers in England and Wales showed 18 new cases of pulmonary tuberculosis in 1971, a five-times increased risk of acquiring the disease compared with the general population. Technicians were at greatest risk, especially if they worked in morbid anatomy departments. Of the 35 cases of hepatitis, the technicians were again the occupational group most likely to acquire the disease. Microbiology staff were twice as likely to report shigellosis as those in other pathology divisions but only one case of brucellosis was reported in the whole laboratory population. A similar survey carried out in 1973 of 3000 Scottish medical laboratory workers corroborates the results from England and Wales. Medical laboratory workers continue to experience a considerable risk of developing an occupationally acquired infection. Improvements in staff safety and health care seem to be necessary.

Brucellosis↗
PubMed2003

[Health in the immigrant population: prevalence of latent tuberculosis, hepatitis B, hepatitis C, human immunodeficiency virus and syphilis infection].

INTRODUCTION: To describe the prevalence of infectious diseases in immigrants. METHODS: The Mantoux tuberculin skin test and serology testing for hepatitis B, hepatitis C, HIV and syphilis were performed in 488 immigrants. RESULTS: A positive reaction to the Mantoux (> or = 10 mm) was found in 19.1% of individuals from Africa, 9.6% from Eastern Europe and 5.8% from South America (p < 0.001). With regard to hepatitis B, 2.5% of the Africans, 2.1% of the Eastern Europeans and none of the South Americans were carriers of the virus (p 5 0.02). CONCLUSIONS: The prevalence of infectious diseases in immigrants varies according to their country of origin.

Adult↗