Varma Sagar, M Lakshmi, Moorthy Swathy, Bhaskar Emmanuel
Internal Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND.
Cureus. 2024 Oct 5;16(10):e70883. doi: 10.7759/cureus.70883. eCollection 2024 Oct.
Concurrent tubercular involvement of two or more non-contiguous organs is termed disseminated tuberculosis (TB) and is rare in immunocompetent patients. We describe the case of a young immunocompetent woman with disseminated TB who presented with primary complaints of amenorrhea and dysuria. Abdominal ultrasound showed a uterine cervical mass, which on histopathological evaluation revealed epithelioid granulomata with Langhans giant cells and acid-fast bacilli (AFB). Her chest radiograph showed scattered air space opacities bilaterally, and contrast-enhanced computed tomography of the abdomen revealed the involvement of bilateral kidneys, para-aortic lymph nodes, adrenals, sacroiliac regions, and the gastrointestinal tract. A colonoscopy picked up an ulcer in the terminal ileum, which on histopathology was positive for AFB. The patient was started on anti-tubercular treatment.
两个或更多非相邻器官同时发生结核累及被称为播散性结核病（TB），在免疫功能正常的患者中较为罕见。我们描述了一例患有播散性结核病的年轻免疫功能正常女性病例，其主要主诉为闭经和排尿困难。腹部超声显示宫颈有肿物，经组织病理学评估发现有上皮样肉芽肿，伴有朗汉斯巨细胞和抗酸杆菌（AFB）。她的胸部X线片显示双侧散在的气腔模糊影，腹部增强计算机断层扫描显示双侧肾脏、腹主动脉旁淋巴结、肾上腺、骶髂区域和胃肠道均有累及。结肠镜检查发现回肠末端有一处溃疡，组织病理学检查显示抗酸杆菌阳性。该患者开始接受抗结核治疗。
