Unit of Internal Medicine, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
Unit of Radiology, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
Medicina (Kaunas). 2023 Feb 4;59(2):293. doi: 10.3390/medicina59020293.
Abdominal pain represents a frequent symptom for referral to emergency departments and/or internal medicine outpatient setting. Similarly, fever, fatigue and weight loss are non-specific manifestations of disease. The present case describes the diagnostic process in a patient with abdominal pain and a palpable abdominal mass. Abdominal ultrasonography confirmed the presence of a mass in the mesogastrium. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans oriented toward calcific lymphadenopathies with increased metabolism in the positron emission tomography-computed tomography (PET-CT) scan. Laboratory examinations were inconclusive, although serology for Brucella and the Quantiferon test were positive. After multidisciplinary discussion, the patient underwent surgical excision of the abdominal mass. Histological examination excluded malignancies and oriented toward brucellosis in a patient with latent tuberculosis. The patient was treated with rifampin 600 mg qd and doxycycline 100 mg bid for 6 weeks with resolution of the symptoms. In addition, rifampin was continued for a total of 6 months in order to treat latent tuberculosis. This case underlines the need for a multidisciplinary approach in the diagnostic approach to abdominal lymphadenopathies.
腹痛是转诊至急诊部门和/或内科门诊的常见症状。同样，发热、乏力和体重减轻也是疾病的非特异性表现。本病例描述了 1 例腹痛和可触及腹部肿块患者的诊断过程。腹部超声检查证实中腹部存在肿块。计算机断层扫描（CT）和磁共振成像（MRI）扫描提示钙化性淋巴结病，正电子发射断层扫描-计算机断层扫描（PET-CT）扫描显示代谢增加。实验室检查结果不确定，尽管布鲁氏菌血清学和 Quantiferon 试验阳性。经过多学科讨论，患者接受了腹部肿块切除术。组织学检查排除了恶性肿瘤，并提示潜伏性结核病患者患有布鲁氏菌病。患者接受利福平 600 mg qd 和多西环素 100 mg bid 治疗 6 周，症状缓解。此外，为了治疗潜伏性结核病，利福平还继续使用了总共 6 个月。该病例强调了在腹部淋巴结病的诊断方法中需要采用多学科方法。
