A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection

Hickey, Andrew J.; Gounder, Lilishia; Moosa, Mahomed-Yunus S.; Drain, Paul K.

doi:10.1186/s12879-015-0944-6

Cited by 105 publications

(127 citation statements)

References 61 publications

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“…Similarly, histologic evidence of caseating granulomas has shown a median sensitivity of 68% among hepatic TB case series. [10] …”

Section: Discussionmentioning

confidence: 99%

Isolated Tubercular Appendicitis: A Case Report

Singh¹,

Prasadi²,

Gandhi³

2017

AIMDR

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Introduction: Abdominal tuberculosis (TB) comprises approximately 5% of all cases of TB and appendix is a relatively rare site for tuberculosis. In this report we present a case of tubercular appendicitis. Case report: A 40 year old female presented to the casualty ward of our hospital with complaints of pain in abdomen and back since two months. There were 2 to 3 episodes of vomiting and the vomitus was bilious in nature. Abdominal examination revealed a soft abdomen with tenderness in right iliac fossa and rebound tenderness with positive Pointing sign and Rovsing sign. Routine haematological investigations of the patient revealed rised counts with negative viral markers. Ultrasonography of the abdomen revealed a peristaltic, tubular non-compressible structure of 8 mm in diameter in right iliac fossa with severe probe tenderness. We decided to perform appendectomy on the patient using a gridiron incision. Biopsy sample showed obliterated lumen with dense and diffuse infiltration by lymphocytes and many granulomas composed of epithelioid cells, langhans giant cells and lymphocytes. Some of the granulomas showed central areas of caseating necrosis. Based on the findings of the biopsy specimen, the patient was diagnosed with granulomatous appendicitis, suggestive of tuberculosis. Anti-tubercular therapy was started postoperatively. The patient recovered completely after completion of the treatment. Conclusion: Preoperative diagnosis of appendicular TB is difficult because of the non-specific symptoms. In most cases, patients present as appendicitis and postoperative biopsy study confirms the diagnosis.

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“…Similarly, histologic evidence of caseating granulomas has shown a median sensitivity of 68% among hepatic TB case series. [10] …”

Section: Discussionmentioning

confidence: 99%

Isolated Tubercular Appendicitis: A Case Report

Singh¹,

Prasadi²,

Gandhi³

2017

AIMDR

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“…Rift Valley fever primarily affects sheep and cattle in Africa, although humans who have direct contact with animals or is the most common cause of hepatic granulomas (accounting for approximately 50%), as opposed to non-TB-endemic countries where histoplasmosis, sarcoidosis, or PBC are more common etiologies. 171 Sinusoidal congestion and peliosis hepatis may also be seen. 183 Acid-fast bacilli (AFB) smears are positive in 0% to 59% of cases (median 25%), and organisms are more likely to be found with caseating necrosis, but smears may be positive due to infection from nontuberculous mycobacteria.…”

Section: Rift Valley Fevermentioning

confidence: 99%

“…183 Acid-fast bacilli (AFB) smears are positive in 0% to 59% of cases (median 25%), and organisms are more likely to be found with caseating necrosis, but smears may be positive due to infection from nontuberculous mycobacteria. 171,175,176,178 Cultures provide the strongest evidence of hepatic TB, but the sensitivity may be less than 10%. Histologic evidence of caseating granulomas has a median sensitivity of 68% (range: 14% to 100%) and is generally sufficient to establish the diagnosis in TB-endemic areas.…”

Section: Rift Valley Fevermentioning

confidence: 99%

“…Histologic evidence of caseating granulomas has a median sensitivity of 68% (range: 14% to 100%) and is generally sufficient to establish the diagnosis in TB-endemic areas. 171 PCR for M. tuberculosis DNA has a 53% to 88% sensitivity and a 96% to 100% specificity for detecting hepatic TB. 170,184,185 Immunocompromised patients may present with a wasting syndrome in which multiple organs, including the liver, contain necrotic miliary nodules surrounded by histiocytes that do not aggregate into well-formed granulomas.…”

Section: Rift Valley Fevermentioning

confidence: 99%

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Liver and Bile Duct Infections

Masia¹,

Misdraji²

2018

Diagnostic Pathology of Infectious Disease

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“…Approximately 80% of all reported hepatic tuberculosis (TB) cases were due to systemic dissemination of tubercle bacilli 1. Isolated liver involvement is an extremely rare entity, and it constitutes <1% of TB cases with <100 cases reported in the literature 2.…”

Section: Introductionmentioning

confidence: 99%

Isolated hepatobiliary tuberculosis: a diagnostic challenge

et al. 2018

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Hepatobiliary system involvement is frequently seen as part of disseminated tubercular infection. But primary isolated hepatobiliary tuberculosis with no evidence of tuberculosis elsewhere in the body is extremely rare. Isolated hepatobiliary tuberculosis can cause diagnostic dilemma as the clinical, laboratory and imaging features are non-specific in majority of the cases. We report the case of a 50-year-old woman who presented with hepatobiliary tuberculosis with no pulmonary or extra hepatic involvement. Liver function tests were abnormal and ultrasonography (USG), CT and MR cholangiopancreatography showed multiple focal lesions in the liver. The diagnosis of tuberculosis was confirmed by a USG-guided biopsy of the liver lesions. In endemic regions with the presence of supportive imaging findings, in the appropriate clinical setting, the possibility of hepatic tuberculosis should be considered and diagnosis has to be confirmed with histopathological examination.

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A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection

Cited by 105 publications

References 61 publications

Isolated Tubercular Appendicitis: A Case Report

Isolated Tubercular Appendicitis: A Case Report

Liver and Bile Duct Infections

Isolated hepatobiliary tuberculosis: a diagnostic challenge

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