Abdominal tuberculosis in a low prevalence country

Med Mal Infect. 2016 May;46(3):140-5. doi: 10.1016/j.medmal.2016.02.003. Epub 2016 Mar 16.

Abstract

Objective: Abdominal tuberculosis is a rare disease. The clinical and radiological manifestations are non-specific and the diagnosis is difficult. Our objective was to describe the characteristics and treatment of patients presenting with abdominal tuberculosis in a low-incidence country.

Patients and methods: We reviewed the clinical, diagnostic, treatment, and outcome features of patients presenting with abdominal tuberculosis diagnosed by bacteriological and/or histological results and managed in five French university hospitals from January 2000 to December 2009.

Results: We included 21 patients. The mean diagnostic delay was 13 months. Twelve patients (57%) came from a low-incidence area and only two had a known immunosuppressed condition. Eighteen patients (86%) presented with abdominal symptoms. The main organs involved were the peritoneum (n=14, 66%), the mesenteric lymph nodes (n=13, 62%), and the bowel (n=7, 33%). Sixteen patients (76%) underwent surgery, including two in an emergency setting. Seventeen patients (81%) received six months or more of anti-tuberculosis treatment. Finally, 16 patients (76%) had a positive outcome.

Conclusion: New diagnostic procedures, and especially molecular biology, may help diagnose unusual clinical presentations of tuberculosis. Invasive procedures are frequently necessary to obtain samples but also for the treatment of digestive involvement.

Keywords: Adénopathies mésentériques; Mesenteric lymphadenitis; Peritonitis; Péritonite; Tuberculose; Tuberculosis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Africa / ethnology
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Asia / ethnology
  • Delayed Diagnosis
  • Emigrants and Immigrants
  • Female
  • France / epidemiology
  • Humans
  • Interferon-gamma Release Tests
  • Male
  • Middle Aged
  • Peritonitis, Tuberculous / diagnosis
  • Peritonitis, Tuberculous / drug therapy
  • Peritonitis, Tuberculous / epidemiology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Symptom Assessment
  • Treatment Outcome
  • Tuberculosis, Gastrointestinal / diagnosis
  • Tuberculosis, Gastrointestinal / drug therapy
  • Tuberculosis, Gastrointestinal / epidemiology*
  • Tuberculosis, Gastrointestinal / surgery
  • Tuberculosis, Hepatic / diagnosis
  • Tuberculosis, Hepatic / drug therapy
  • Tuberculosis, Hepatic / epidemiology
  • Tuberculosis, Lymph Node / diagnosis
  • Tuberculosis, Lymph Node / drug therapy
  • Tuberculosis, Lymph Node / epidemiology*
  • Young Adult

Substances

  • Antitubercular Agents