Risk Factors and Diagnositic Challenges of Abdominal Tuberculosis: A Case Report
Published: 2022-11-02
Page: 198-204
Issue: 2022 - Volume 5 [Issue 1]
Diri, Robert Ogbodede
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
Amadi, Ekechi Stella *
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State / College of Medical Sciences, Rivers State University, Nkpolu-Oroworukwo, Nigeria.
Agbarakwe, Blessing
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
Amaewhule, Mary Nneda
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State / College of Medical Sciences, Rivers State University, Nkpolu-Oroworukwo, Nigeria.
Aprioku, Esther
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
Nonju, Tamunobarabiye
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State / College of Medical Sciences, Rivers State University, Nkpolu-Oroworukwo, Nigeria.
Nwamadi, Christian Chisom
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
Rotifa, Oluwafemi
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
Wakama, Rita
Dermatology and Pulmonology Unit, Rivers State University Teaching Hospital, Harley Street Old GRA Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
This is a case of a 30 year old female who presented with a 4 month history of progressive abdominal swelling and mild abdominal discomfort. She had a past history of poorly treated pulmonary tuberculosis however during current symptoms the usual screening tests for tuberculosis such as the gene-xpert test, chest radiograph and acid-alcohol fast bacilli smear and culture were negative creating a diagnostic challenge and considerations for alternative diagnosis to abdominal tuberculosis. Other supportive evidence and risk factors for abdominal tuberculosis were sought for. The treatment was initiated when other likely diagnoses were excluded. Patient made remarkable improvement after starting anti-Koch’s therapy.
Keywords: Abdominal, challenges, diagnostic, risk factors, tuberculosis
How to Cite
Downloads
References
Sousa MD, Batista J, Pacheco P, Nunes V. Abdominal tuberculosis: an old disease surprising young doctors. BMJ Case Rep; 2016.
Sheer TA, Coyle WJ. Gastrointestinal tuberculosis. Curr Gastroenterol Rep. 2003;5(4):273-8.
Skopin MS, Batyrov FA, Kornilova ZKh. The prevalence of abdominal tuberculosis and the specific features of its detection. Probl Tuberk Bolezn Legk. Russian. 2007;(1):22-6.
Cho JK et al. Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience. BMC Infect Dis. 2018;18:699.
Urabinahatti KA et al. Abdominal tuberculosis: an epidemiological profile and management of 40 cases in a tertiary set up. Int Surg J. 2016;3:1502-8.
Affusim CC, Kesieme E, Abah VO. The pattern of presentation and prevalence of tuberculosis in HIV-Seropositive patients seen at Benin City, Nigeria. ISRN Pulmonology; 2012.
Article ID 326572
Anonymous. Management of non-respiratory tuberculosis. The Lancet. 1968;1:1423-4.
Edafe AE, Alasia DD, Akpa MR. Abdominal tuberculosis mimicking intra-abdominal malignancy: a case report. The Nigerian Health Journal. 2015;15(4).
Ferreira C, Pinto T, Neves I, Duarte R. Gender differences in active tuberculosis. European Respiratory Journal. 2014;44:P2688.
Ben Jmaa M, Ben Ayed H, Koubaa M, Hammami F, Damak J, Ben Jemaa M. Is there gender inequality in the epidemiological profile of tuberculosis? Tunis Med. 2020;98(3):232-240.
Jemaa MB et al. 762 sex differences in the epidemiology of tuberculosis in Tunisia. Open Forum Infectious Diseases. 2018; 5(suppl_1):S274.
Ihekwaba FN. Abdominal tuberculosis: a study of 881 cases. J R Coll Surg Edinb. 1993;38(5):293-5.
Akinkuolie AA, Adisa AO, Agbakwuru EA, Egharevba PA, Adesunkanmi AR. Abdominal tuberculosis in a Nigerian teaching hospital. Afr J Med Med Sci. 2008;37(3):225-9.
Chakinala RC, Khatri AM. Gastrointestinal tuberculosis.
Available: :https://www.ncbi.nlm.nih.gov/books/NBK556115/
Accessed (10-09-2022).
Yen YF et al. Association of body mass index with tuberculosis mortality: A population-based follow-up study. Medicine (Baltimore). 2016;95(1).
Kitonsa PJ et al. Evaluation of underweight status may improve identification of the highest-risk patients during outpatient evaluation for pulmonary tuberculosis. PLoS ONE. 2020;15(12): e0243542.
Lerner BH. Can stress cause disease? Revisiting the tuberculosis research of Thomas Holmes, 1949-1961. Ann Intern Med. 1996;124(7):673-80.
Tola HH et al. Psychological distress and its effect on tuberculosis treatment outcomes in Ethiopia. Glob Health Action; 2015.
Rice University. Study could explain tuberculosis bacteria paradox. Science daily.
Available:https://www.sciencedaily.com/releases/2021/02/210222124608.htm,
Accessed (22-10-2022)
Steingart KR, Sohn H, Schiller I, Kloda LA, Boehme CC, Pai M, Dendukuri N. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults; 2018.
Available: https://www.ncbi.nlm.nih.gov/pubmed/24448973 Cochrane Database Syst Rev. 2013 1:9593
Tortoli E et al. Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis. Eur Respir J. 2012;40:442–447.
Meyer A et al. Sputum quality and diagnostic performance of Gene Xpert MTB/RIF among smear-negative adults with presumed tuberculosis in Uganda. PLoS One. 2017;12(7):e0180572.
Abu-Zidan FM, Sheek-Hussein M. Diagnosis of abdominal tuberculosis: lessons learned over 30 years: pectoral assay. World J Emerg Surg. 2019;14:33.
Ahmad R, Changeez M, Khan JS, Qureshi U, Tariq M, Malik S, Ahmad SH, Shafique MS. Diagnostic accuracy of peritoneal fluid gene xpert in the diagnosis of intestinal tuberculosis, keeping histopathology as the gold standard. Cureus. 2018;10(10):e3451.
Phyu MH, Kyaw KWY, Myint Z, Thida A, Satyanarayana S, Aung ST. Sputum smear-positive, Xpert® MTB/RIF-negative results: magnitude and treatment outcomes of patients in Myanmar. Public Health Action. 2018;8(4):181-186.
Baraua, Hossana M. Adenosine deaminase in diagnosis of tuberculosis: A Review. Anwer Khan Modern Medical College Journal. 5(2):43–48.
Atta S, Kassem A, Elhadidi A, Esawy HE. The diagnostic value of adenosine deaminase activity in pulmonary tuberculosis: Comparison between sputum and serum. Egyptian Journal of Chest Diseases and Tuberculosis. 2015;64(1): 103-107.
Mohammed TJM, Wafaa H, Wafaa B. Adenosine Deaminase (ADA) in peritoneal tuberculosis.
Accessed (25-09-2022)
Dale CL et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Clinical Infectious Diseases, ciaa241; 2020.
CDC. Treatment of tuberculosis disease.
Available:https://www.cdc.gov/tb/education/corecurr/pdf/chapter6.pdf,
Accessed (25-09-2022)