Tuberculosis: a surgical viewpoint.

Over the past 15 years, 32 cases of tuberculosis have been seen and diagnosed in the surgical and gynaecological departments of the Northern General Hospital, Sheffield. The average age of patients was 42.8 years. Of the sites affected, 17 had head, neck or axillary swellings, 6 affected the female genital tract, 3 had intra-abdominal tuberculosis, 2 presented with soft tissue swellings on the trunk or limbs, 2 affected the male genitourinary system, whilst the remaining cases presented with an ischiorectal and psoas abscess. The time delay between initial consultation and diagnosis being established was between 1 and 8 months. In only 7 (21.8%) cases was a correct preoperative diagnosis made, with only 8 patients being clinically unwell at presentation. Twenty-three received antituberculous chemotherapy and there was one death. Tuberculosis will not be diagnosed or correctly treated unless it is considered in the differential diagnosis and appropriate specimens sent for bacteriology and histology. We conclude that tuberculosis is still prevalent in the surgical departments and both general surgeons and gynaecologists should consider the diagnosis more frequently than is currently the case.