Abdominal Tuberculosis in Adult: 10-Year Experience in a Teaching Hospital in Central Taiwan

作者：Chou Chia Huei; Ho Mao Wang; Ho Cheng Mao; Lin Po Chang; Weng Chin Yun; Chen Tsung Chia; Chi Chih Yu^*; Wang Jen Hsian

来源：Journal of Microbiology, Immunology, and Infection, 2010, 43(5): 395-400.

DOI：10.1016/S1684-1182(10)60062-X

• abdomen
• granuloma
• peritoneum
• Taiwan
• tuberculosis

BACKGROUND/PURPOSE: Tuberculosis (TB) is an important communicable disease worldwide The clinical presentation of abdominal TB often mimics various gastrointestinal disorders and may delay accurate diagnosis. In this study, we conducted a 10-year retrospective study to investigate the clinical manifestations, treatment responses and outcomes of abdominal TB.
METHODS: This retrospective study recruited patients presenting between January 1998 and December 2007, all patients 18 years of age with a diagnosis of abdominal TB were enrolled. Patient charts were thoroughly reviewed and clinical specimens were processed in the laboratory using the BBL MycoPrep System and BACTEC MGIT 960 Mycobacterial Detection System. Mycobacterium tuberculosis complex was confirmed by acid fast stain and the BD ProbeTec ET System.
RESULTS: During the study period, 34 patients were diagnosed with abdominal TB. The mean age was 55 18 years. Fourteen patients (41%) had no risk factors; however, 20 patients (59%) had at least one risk factor. Abdominal pain (94.1%), abdominal fullness (91 2%), anorexia (88.2%) and ascites (76 5%) were the most common presenting symptoms. The peritoneum (88%) was the most commonly involved site Patients with risk factors such as liver cirrhosis, end-stage renal disease and diabetes mellitus had a higher positive rate of stain and mycobacterial culture from abdominal specimens (p=0 02 and 0 05, respectively). The crude mortality rate was 9% and the attributed mortality rate was 3%.
CONCLUSION: In an endemic area like Taiwan, regardless of whether a patient has risk factors for TB, abdominal TB should be seriously-considered as a differential diagnosis when a patient presents with gastrointestinal symptoms and unexplained ascites.

• 出版日期2010-10
• 单位中国医科大学