Objective. To describe the clinical, biochemical, microbiologic, radiologic and histological features and outcome of intestinal TB.Methods. Medical records of patients diagnosed with intestinal TB were reviewed. Cases were considered bacteriologically-confirmed if intestinal tissue was positive on smear culture or polymerase chain reaction (PCR); and clinically-diagnosed if with clinical, histologic, and radiologic evidence of extra-pulmonary TB. Results. Fifteen patients [Mean (SD) age: 13 (4) years; 53% females] were included. One was bacteriologicallyconfirmed; and fourteen were clinically-diagnosed. Fever (87%) and abdominal pain (73%) were commonly seen. Seven (47%) had anemia, 5 (33%) leukocytosis and 10 (71%) hypoalbuminemia. Eleven (73%) were positive on smear or TB PCR of various specimens. Nine of 10 (90%) patients with an abdominal CT scan had thickening of bowel loops. Three with intestinal biopsy demonstrated caseation granuloma. Fourteen patients were given quadruple anti-TB medications. Six had surgery, 8 had no disease-related complications, 4 died of sepsis and 3 were lost to follow up.Conclusion. Intestinal TB presents with non-specific clinical and laboratory features. Radiologic findings may provide a clue to the diagnosis. Histologic confirmation in intestinal tissue was only seen in a few cases. The prognosis was favorable for patients who completed the anti-TB treatment.
Background. The features and outcome of hepatobiliary tuberculosis (HBTB) have not been extensively reportedin children. Objective. To describe the clinical, biochemical, radiologic, microbiologic and histologic features and outcome ofchildren diagnosed with HBTB. Methods. Data of HBTB patients aged 0-18 years were collected by review of medical records and as they wereadmitted. Cases were classified as bacteriologically-confirmed (positive AFB smear, TB culture or PCR of bile/livertissue) or clinically-diagnosed (clinical, histologic and/or radiologic evidence). Results. A total of 36 patients were included (mean age: 13yrs; 64% males): three bacteriologically-confirmed and33 clinically-diagnosed. Most common signs/symptoms were weight loss (69%), fever (67%), hepatomegaly (61%)and jaundice (53%). Of the total, 68% had hypoalbuminemia, 50% increased transaminases and 47% prolongedprothrombin time. Fifteen (42%) patients were AFB positive on various microbiologic specimens. Most commonimaging finding was hepatic calcification (64%). Of 11 patients with liver biopsy, seven (64%) had chronic/granulomatous inflammation. All 36 were managed medically. Eight were lost to follow up, six died, and 22 (61%)are alive, nine with complete resolution of liver disease. Conclusion. Hepatobiliary tuberculosis presents with non-specific clinical and biochemical findings. Severalinvestigations are necessary to confirm the diagnosis. Overall response to anti-TB treatment is satisfactory withpossible resolution of liver disease.
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