Aubry P, Reynaud J P, Nbonyingingo C, Ndabaneze E, Mucikere E
Hôpital d'Instruction des Armées Robert Picqué, Bordeaux-Armées.
Ann Gastroenterol Hepatol (Paris). 1994 Mar-Apr;30(2):43-52.
A systematic abdominal study of the solid organs of the abdomen (liver, spleen, pancreas, kidneys) carried out in one hundred patients from Central Africa suffering from full blown AIDS revealed disseminated hyperechoic liver in 37 cases and hypoechoic nodules of the spleen in 10 cases. The combination with abdominal adenopathy and/or serous exudates (peritoin, pleura, pericardium) suggested disseminated tuberculosis. Twenty of the 37 patients with diffusely hyperechoic liver presented within tuberculosis which was confirmed by bacteriological data (AARB present in the sputum) in 13 cases. Of the 10 patients presenting with hypoechoic nodules of the spleen, 5 presented with confirmed tuberculosis. These 10 patients were all considered to have disseminated tuberculosis. In view of the current high incidence of extrapulmonary or disseminated tuberculosis occurring in a context of AIDS and the relative infrequency of positive tests for Mycobacterium, abdominal ultrasound must be coupled with chest X-rays in screening and prompt follow-up for TB instigated in HIV-positive adult Africans.