Dept. of Internal Medicine, University Hospital Ulm, Germany.
Infection. 2010 Feb;38(1):69-72. doi: 10.1007/s15010-009-9469-5. Epub 2009 Nov 10.
We report on a 20-year-old woman with abdominal tuberculosis.Standard microbiological examination of ascites showed no acid-fast bacilli (AFB), and analysis for the Mycobacterium tuberculosis (MTB)-complex DNA by PCR was negative. However,the interferon-gamma release assay (IGRA) of the ascites was positive after specific stimulation with mycobacterial antigens(ESAT-6/CFP-10/TB7.7[p4]), indicating an infection with MTB.The diagnosis of tuberculosis was later confirmed by histology, MTB culture, and PCR analysis of MTB-complex DNA in tissue samples taken during laparoscopy. Thus, the IGRA of ascites may guide the decision to start active treatment for tuberculosis.
我们报告了一例 20 岁女性的腹腔结核病例。腹水的标准微生物学检查未发现抗酸杆菌(AFB),聚合酶链反应(PCR)分析结核分枝杆菌(MTB)-复合 DNA 也是阴性。然而,腹水经分枝杆菌抗原(ESAT-6/CFP-10/TB7.7[p4])特异性刺激后的干扰素 -γ释放试验(IGRA)呈阳性,提示 MTB 感染。后来通过腹腔镜检查获取的组织样本进行组织学、MTB 培养和 MTB-复合 DNA 的 PCR 分析,确诊了结核病。因此,腹水的 IGRA 可能有助于决定开始针对结核病的积极治疗。