Splenic tuberculosis caused by hematogenous pulmonary tuberculosis: a case report and literature review
10.16718/j.1009-7708.2018.02.008
- VernacularTitle:血行播散型结核致脾结核1例并文献复习
- Author:
Ke XIAO
1
;
Dongxia ZHAO
;
Xuejiao SHUI
;
Li ZHONG
;
Fuli HUANG
Author Information
1. 西南医科大学附属医院感染科
- Keywords:
splenic tuberculosis;
hematogenous tuberculosis;
anti-tuberculosis treatment
- From:
Chinese Journal of Infection and Chemotherapy
2018;18(2):171-176
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the clinical features of splenic tuberculosis. Methods The clinical manifestations, laboratory tests, treatment outcomes of a case of splenic tuberculosis caused by hematogenous pulmonary tuberculosis were analyzed. Related literatures about splenic tuberculosis were also reviewed. Results The patient was a 19-year-old male. Cough, fever, night sweats, and weight loss were the main manifestations. Thoracoscopy revealed tuberculosis and imaging suggested splenic tuberculosis and tuberculosis in multiple body sites. Anti-tuberculosis treatment was effective in improving patient conditions. According to literature review, there are two types of splenic tuberculosis: primary splenic tuberculosis or as part of hematogenous pulmonary tuberculosis.The clinical manifestations of primary splenic tuberculosis are usually atypical. Immune deficiency is a significant risk factor of splenic tuberculosis. The main clinical manifestations of splenic tuberculosis are splenomegaly, fever, digestive system symptoms, and occasionally spontaneous splenic rupture (3/32). Most of the patients with splenic tuberculosis (28/32) were cured or improved by anti-tuberculosis treatment and/or splenectomy. Conclusions The onset of splenic tuberculosis is mostly insidious and clinical symptoms usually atypical. The diagnosis relies on radiographic findings, biopsy and pathological examination. Anti-tuberculosis and selective splenectomy are the effective treatment. The outcome of splenic tuberculosis is good in most patients.
