Isolated tuberculous liver abscess in immunocompetent children – Report of two cases

Bhatt, Girish Chandra; Nandan, Devki; Singh, Sarman

doi:10.1179/2047773212y.0000000071

Cited by 10 publications

(8 citation statements)

References 8 publications

(8 reference statements)

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“…The clinical presentation of this patient with abdominal pain, and weight loss in the absence of fever throughout his admission both at local and tertiary hospitals was confusing making hepatocellular carcinoma most likely. Despite the fact that there is no pathognomonic feature of local hepatic tuberculosis, some or all symptoms together were present in most of the previous case reports (Oliva et al, 1990;Hassan et al, 2010;Bhatt et al, 2013).…”

Section: Discussionmentioning

confidence: 88%

“…Tubercular liver abscess, when present, is usually associated with the focus of infection in the lung or in the gastrointestinal tract (Javid, 1998), or is associated with an immunocompromised state (Maharaj et al, 1987;Amarapurkar et al, 1995). Cases of isolated hepatic tuberculosis are also not uncommon in immunocompetent patients especially with history of contact with patients with tuberculosis (Hassan et al, 2010;Bhatt et al, 2013). The pathogenesis of hepatic tuberculosis is by haematogenous dissemination, the portal of entry being hepatic artery for hepatic miliary tuberculosis and portal vein for focal liver tuberculosis (Javid et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

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Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

Setime

Rwegerera

Chowdhury

2014

Tanzania J Hlth Res

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Isolated hepatic tuberculosis presenting as a mass either with or without fever can be confused with hepatocellular carcinoma. Clinical examination and laboratory investigations are not specific. Radiological investigations such as ultrasound and computed tomography cannot confirm the diagnosis; hence it is vital to always make an effort to demonstrate presence of acid fast bacilli in aspirated pus or necrotic material from a liver mass. We present a case of 50 years old male patient with HIV/AIDS who presented with non-specific symptoms without fever, clinically with hepatomegaly mimicking hepatocellular carcinoma with metastasis.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

Setime

Rwegerera

Chowdhury

2014

Tanzania J Hlth Res

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“…Hepatic TB accounts for 1.2% of all TB cases and TB liver abscesses develop in 0.34% of hepatic TB cases (35). Overall, about 25 cases of isolated TB liver abscess have been reported in the English literature before 2003, while pediatric cases remain scarce (35)(36)(37)(38). The diagnosis of a TB abscess remains challenging because of the lack of a specified presentation and the limited yield of tests.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

et al. 2020

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Background: Liver abscess is an important but relatively rare disease in children. This study investigated the clinical characteristics of eligible patients at a referral tertiary center over the past two decades. Method: A 20-year retrospective study (January 2000-December 2019) enrolled 38 children diagnosed with liver abscess. Demographic data; clinical features; laboratory, imaging, and microbiological findings; management strategy; and outcomes were reviewed from the patients' medical records. Results: Thirty-eight cases of pyogenic liver abscess were identified without a culture-proven amebic or fungal abscess. The mean age of diagnosis was 9.6 ± 6.2 years, and the male-to-female ratio was 1.92: 1. Hemato-oncological (28.9%) and predisposing hepatobiliary diseases (23.7%) were the two most common predisposing factors. Fever (94.7%) was the most common presentation followed by right upper quadrant abdominal pain (42.1%) and pleural effusion (34.2%). Among the laboratory parameters, leukocytosis was common (70.3%), and all patients had elevated serum C-reactive protein levels. Increased serum levels of alanine aminotransferase, aspartate aminotransferase, direct bilirubin, and total bilirubin were found in 40.5, 48.6, 23.1, and 42.9% of the cases, respectively. The most common pathogen in blood and pus cultures was Klebsiella pneumoniae. The mean durations of intravenous antibiotic and total antibiotic use were 29.0 ± 15.7 and 45.1 ± 22.1 days, respectively. Twelve patients (31.6%) were treated with antibiotics alone, while percutaneous needle aspiration, percutaneous pigtail drainage, and surgical intervention were performed in 12 (31.6%), 10 (26.3%), and 5 (13.2%) patients, respectively. No mortality was documented in this series. Conclusion: The present study reflects a relatively declining incidence of liver abscess compared with prior studies in Taiwan. K. pneumoniae remains the most prevalent pathogen in both blood and abscess cultures in Taiwan. Proper antimicrobial therapy with timely drainage generally yielded an adequate treatment response without any mortality.

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“…Recently, PCR technique has been used to diagnose M. tuberculosis infection, which has added advantage of differentiate between M. tuberculosis from non-tuberculous mycobacterium. 10…”

Section: Discussionmentioning

confidence: 99%

Isolated cold abscess of the thigh in an immunocompetent infant

Sharma

Bhatt

et al. 2014

Trop Doct

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Isolated tuberculous liver abscess in immunocompetent children – Report of two cases

Cited by 10 publications

References 8 publications

Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

Isolated tubercular hepatic abscess with diffuse pattern mimicking hepatocellular carcinoma in HIV positive patient: a case report

Pediatric Liver Abscess: Trends in the Incidence, Etiology, and Outcomes Based on 20-Years of Experience at a Tertiary Center

Isolated cold abscess of the thigh in an immunocompetent infant

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