Abdominal ultrasound findings of disseminated tuberculosis in AIDS

Monill-Serra, J. M.; Martínez-Noguera, Antonio; Montserrat, Enric; Maideu, J.; Sabaté, Josep M.

doi:10.1002/(sici)1097-0096(199701)25:1<1::aid-jcu1>3.0.co;2-m

Cited by 28 publications

(31 citation statements)

References 21 publications

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“…Peritoneal involvement occurs in 4-10% patients of extra pulmonary tuberculosis (EPTB). 6 Tubercular peritonitis follows either the direct spread of tuberculosis from ruptured lymph nodes and intra-abdominal organs or haematogenous seeding. Peritoneal involvement may be in the form of peritoneal adhesions or exudative fluid in the peritoneal cavity (ascites).…”

Section: Discussionmentioning

confidence: 99%

“…Gastric tuberculosis though rare but is commoner than oesophageal, duodenal, appendicular and anal tuberculosis. 6 In order of frequency, abdominal tuberculosis manifests as tubercular lymphadenitis, peritonitis and hepatosplenic or pancreatic tuberculosis. The disease may present at any age but commonly seen in young adults.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Enlarged lymph nodes predominantly hypoechoic/ necrotic, size of lymph nodes greater than 15 mm. Hypoechoic nodes means that hilar echogenicity of the nodes are lost.…”

Section: Discussionmentioning

confidence: 99%

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Clinical profile of 128 HIV positive cases with abdominal tuberculosis

et al. 2016

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Background: Tuberculosis and HIV co-infection remains a major public health challenge throughout the world. An extra 25% of deaths among TB patients are attributable to co-infection with HIV according to the WHO 2009 TB report. TB is often the first opportunistic infection and a leading cause of death in HIV infected persons. The main objective was to study the clinical profile of the patients co-infected with HIV and abdominal tuberculosis in Government Medical College, Aurangabad.Methods: Patients co-infected with HIV and abdominal tuberculosis were included in this observational study. Patients were either HIV positive and later diagnosed to have abdominal tuberculosis or diagnosed to be HIV positive when investigations were done after the diagnosis of abdominal TB. The common presenting symptoms were weight loss, fever, loss of appetite, pain in the abdomen and chronic diarrhoea. Ultrasound and routine chest X-ray were done along with other routine blood investigations including CD4 count.Results: We studied 407 cases of HIV-TB co-infected patients out of whom 248 (61%) were of extra-pulmonary tuberculosis. Out of 248, 128 cases (51.6%) were diagnosed to have abdominal tuberculosis which was the commonest type of extra pulmonary tuberculosis in HIV –TB co- infected patients. They had higher morbidity, but we found that 96.06% patients completed anti-tubercular treatment and responded. Mortality rate of abdominal TB was lowest (3.94%) among all types of extra-pulmonary and also pulmonary TB in HIV co -infected patients. So we can conclude that HIV TB co infected patients show good response to anti- tubercular treatment if we diagnose this condition early.Conclusions: Abdominal tuberculosis is the commonest type of extra pulmonary tuberculosis in HIV patients. On ultrasonography, the common abnormalities seen were intra-abdominal lymphadenopathy, splenic abscesses, ascites etc. All the patients who were diagnosed within few weeks of symptoms recovered with anti tubercular therapy, similar to HIV negative patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical profile of 128 HIV positive cases with abdominal tuberculosis

et al. 2016

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“…In autopsies of cases with disseminated pulmonary tuberculosis, hepatosplenic involvement was reported to be as high as 80-100% (Thoeni and Margulis 1979). Macronodular involvement is extremely rare and is more frequent in HIV positive patients with a rate of around 15% (Monilla-Serra et al 1997). The differentiation of macronodular involvement in the form of localized tumoral mass from other solid masses of the spleen is extremely difficult (Akhan et al 2002;Sheen-Chen et al 1995).…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of Tuberculosis as a Splenic Mass

Dede

Dogan

Demir

et al. 2006

Tohoku J. Exp. Med.

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Tuberculosis is an important health problem in developing countries, with varying clinical presentations depending on the organs/systems involved. Tuberculosis is mostly seen in immuno-compromised individuals, such as those with acquired immune deficiency syndrome or malignancies. Here we report a case of a spleen tuberculoma in a 29-year-old male patient with no known immune deficiency. He first presented with abdominal pain, and subsequent ultrosonographic examination revealed a splenic lesion of 10 cm in diameter. A computerized tomography scan of the abdomen confirmed the presence of a solitary, hypodense, septated cystic lesion. Lack of evidence supporting the presence of a splenic infection or a primary/metastatic malignancy prompted explorative surgery where a septated abscess formation was discovered and splenectomy was performed. Histopathological examination revealed granulomatous inflammatory changes with Langerhans-type giant cells, which are consistent with tuberculosis. For a period of two months, antituberculosis therapy with four drugs, isoniazid, rifampicin, pyrazinamide, and ethambutol, was carried out. Pyrazinamide and ethambutol were quitted at the end of two months. Theraphy with isoniazid and rifampicin was planned for an additional 10 months. We would like to call attention to yet another atypical presentation of extrapulmonary tuberculosis. spleen tuberculosis; abdominal tuberculosis; splenic abscess

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“…The following features on USG were considered suggestive of abdominal tuberculosis as demonstrated by other studies. [13][14][15] • Enlarged lymph nodes predominantly hypoechoic/necrotic. Size of lymph nodes greater than 15 mm was considered tubercular.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Clinico-radiological profile of abdominal tuberculosis in HIV/AIDS patients-a study from rural central India

et al. 2017

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Background: One of the major challenge of present era is dual epidemic of HIV/AIDS and tuberculosis. With immunosuppression, risk of opportunistic diseases increases in these patients and tuberculosis is most common opportunistic infection. The prevalence of abdominal tuberculosis seems to be rising, particularly due to increasing prevalence of HIV infection. The diagnosis of abdominal tuberculosis can often be difficult and it remains underdiagnosed, in view of its nonspecific manifestations. The investigations involved in its diagnosis are expensive and time consuming, however, ultrasonography (USG) is an affordable, non-invasive and widely available modality which can be of help in the diagnosis of abdominal tuberculosis. Therefore, this study was undertaken to evaluate clinical and USG finding among Abdominal Tuberculosis patients with HIV/AIDS. Methods: After informed consent, patients underwent thorough history taking and clinical examination followed by high quality USG abdomen and other biochemical and haematological tests including CD4 count. Follow up USG abdomen was done at time of completion of course of ATT and data was analysed. Results: 45 were found to have abdominal tuberculosis. Of these patients, 31(68.9%) were male and 14 (31.1%) were female. Mean age of HIV-abdominal TB was 34.27±9.66 years. most common symptoms were weight loss 41(91.1%), loss of appetite 38(84.4%), fever 32(71.1%), generalized weakness 30(66.7%) and abdominal pain 27(60.0%). On USG abdomen, intraabdominal lymphadenopathy was most common finding found in 44(97.8%). Average size of enlarged lymph node was 3.1+-1.0 cm. Mesenteric lymphnodes were enlarge in 40(88.89%), paraaortic 8(17.78%), retroperitoneal 4(8.89%) while peripancreatic and porta hepatic in 3(6.67%). splenomegaly was noted in 14(31.1%) cases. Hepatomegaly was found in 6 cases, who all were male. Ascites was evident in 5(11.1%) patients. Extensive involvement, defined as involvement of two or more intraabdominal sites, was found 24(53.3%) cases. There was no statistically significant difference found among these USG findings and CD4 count. Conclusions: The findings of lymphadenopathy (size>15mm) and hypoechoic/necrotic echotexture, hepatosplenomegaly with hypoechoic lesions in ultrasonography are suggestive of abdominal tuberculosis in HIV infected patients with unexplained nonspecific symptoms and low CD4 count. However, above findings are not standardized and inability to confirm the diagnosis of tuberculosis by direct microscopy and culture is the limitation of this study. Ultrasonography is an affordable, widely available, non-invasive imaging modality which may be optimally utilized for the diagnosis of abdominal tuberculosis in HIV infected patients, especially in the rural setup where microbiological and other sophisticated radiological investigations have limited availability.

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Abdominal ultrasound findings of disseminated tuberculosis in AIDS

Cited by 28 publications

References 21 publications

Clinical profile of 128 HIV positive cases with abdominal tuberculosis

Clinical profile of 128 HIV positive cases with abdominal tuberculosis

Unusual Presentation of Tuberculosis as a Splenic Mass

Clinico-radiological profile of abdominal tuberculosis in HIV/AIDS patients-a study from rural central India

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