Baveja Cp, Gumma Vidyanidhi, Chaudhary Monica, Jha Himanshu
Department of Microbiology, Tuberculosis Laboratory, Maulana Azad Medical College, New Delhi, India.
J Med Case Rep. 2009 Oct 15;3:78. doi: 10.1186/1752-1947-3-78.
Isolated primary tubercular abscess is one of the rare forms of extrapulmonary tuberculosis. A greater awareness of this rare clinical entity may help in commencing specific evidence-based therapy quickly and preventing undue morbidity and mortality.
A 30-year-old man, of Asian origin, developed a hepatic tubercular abscess which was not associated with any pulmonary or gastrointestinal tract foci of tuberculosis. An ultrasonogram of the abdomen showed an abscess in the right lobe of his liver which was initially diagnosed as an amoebic liver abscess. Subsequently, the pus from the lesion yielded Mycobacterium tuberculosis using the BACTEC TB 460 instrument and Mycobacterium tuberculosis deoxyribonucleic acid by polymerase chain reaction. The patient was started on systemic antitubercular therapy to which he responded favorably.
This report emphasizes the fact that, although a tuberculous liver abscess is a very rare entity, it should be included in the differential diagnosis of unknown hepatic mass lesions.
孤立性原发性结核脓肿是肺外结核的罕见形式之一。提高对这种罕见临床实体的认识可能有助于迅速开始基于证据的特异性治疗,并预防不必要的发病率和死亡率。
一名30岁的亚洲男性患肝结核脓肿,与任何肺或胃肠道结核病灶无关。腹部超声检查显示其肝脏右叶有一个脓肿,最初被诊断为阿米巴肝脓肿。随后,使用BACTEC TB 460仪器从病变脓液中培养出结核分枝杆菌,并通过聚合酶链反应检测出结核分枝杆菌脱氧核糖核酸。患者开始接受全身抗结核治疗,反应良好。
本报告强调,尽管结核性肝脓肿是一种非常罕见的疾病,但在不明肝脏肿块病变的鉴别诊断中应考虑到它。