Hepatic tuberculosis:one case report and literature review
10.16718/j.1009-7708.2019.01.007
- VernacularTitle:肝脏结核1例并文献复习
- Author:
Ke XIAO
1
;
Xuejiao SHUI
;
Dongxia ZHAO
;
Fuli HUANG
;
Li ZHONG
Author Information
1. 西南医科大学附属医院感染科
- Keywords:
liver;
tuberculosis;
hepatic tuberculosis;
extrapulmonary tuberculosis
- From:
Chinese Journal of Infection and Chemotherapy
2019;19(1):32-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the clinical features of hepatic tuberculosis. Methods The clinical manifestations, laboratory findings, treatment, and prognosis of a case of hepatic tuberculosis were analyzed. Similar cases were identified from PubMed database during the period from 2013 to 2017 using search terms "Liver/Hepatology/Hepatic Tuberculosis". The clinical data of the identified patients with hepatic tuberculosis were reviewed and analyzed. Results The 16-year-old male patient presented with cough and abdominal distension. His sputum was positive for acid-fast bacillus. CT showed low-density spaceoccupying lesions. After anti-tuberculosis treatment, the lesion disappeared. Hepatic tuberculosis was finally considered, which was caused by disseminated tuberculosis. Literature search identified 63 similar cases. In summary, the 64 cases(containing this one)included 38 males and 26 females with age from 11 months to 77 years. Tuberculosis in other site or underlying disease was found in 39 cases. The main clinical manifestations were fever(51.6％), abdominal pain(50.0％), weight loss(31.2％), loss of appetite(25.0％), tiredness/weakness(21.9％), and nausea/vomiting(20.3％). Low-density space-occupying lesions were the main features on CT image. The diagnosis was confirmed by histopathological and/or bacteriological testing in 59 patients. Five patients were diagnosed after diagnostic anti-tuberculosis treatment was effective. Overall, 36 patients were cured, 19 improved, and 3 died.Conclusions The clinical symptoms of hepatic tuberculosis are atypical. Imaging combined with histopathological examination of the liver is the preferred method for diagnosis of hepatic tuberculosis. Anti-tuberculosis treatment and timely surgical treatment is usually effective with good outcomes.
