[Extrapulmonary tuberculosis: 2 cases with hepatic, splenic, peritoneal and cerebral involvement].

Two cases of unusual extrapulmonary tuberculosis are presented. One patient was suffering of a pulmonary tuberculosis involving the brain, liver, spleen and peritoneum, with headaches, ascites, weight loss and night sweats. The other patient had lymph nodes and nodular liver tuberculosis and complained of fever, right upper quadrant pain, anorexia and weight loss. This tuberculosis form is extremely rare; only 23 cases were reported between 1950 and 1990. Furthermore, a drug-induced hepatitis developed in a liver already damaged by the tuberculosis and a chronic active C hepatitis. These two cases remind us that the diagnosis of extrapulmonary tuberculosis may be extremely difficult. It must be suspected mostly in patients that are immuno-depressed or whose origins are not caucasian. Other diagnoses are often wrongly suggested, such as tumors, inflammatory diseases or other infectious diseases. As a result, the correct diagnosis or other infectious diseases. As a result, the correct diagnosis is often delayed. If cultures are negative and the chest roentgenogram is normal, procedures such as transbronchial, liver, bone marrow or lymph node biopsies may help to properly identify the disease.