Disseminated tuberculosis involving liver and lymph nodes: a case report and review of the literatures

Abstract

Abstract: Objective To understand the clinical features of hepatic and disseminated tuberculosis. Methods This study analyzes the clinical presentations, laboratory and imaging findings, treatment strategies and prognosis of a patient diagnosed with disseminated tuberculosis involving the liver and lymph nodes by the Department of Infectious Diseases at Huashan Hospital, affiliated with Fudan University. A comprehensive review was conducted of literature form Pubmed and Chinese databases soanning the years 2003 to 2022, focusing on . hepatic tuberculosis and disseminated tuberculosis. Reports pertinent to disseminated hepatic tuberculosis were meticulously screened, and relevant clinical data were extracted and evaluated to underscore patterns, outcomes, and insights into this condition. Results Presented is the case of an elderly male suffering from recurrent epidodes of fever, fatigue, and anorexia, with no response to various anti-infective treatments. Comprensive imaging examinations revealed the presence of multiple abnormal metabolic hypertrophy lesions across the body. The diagnosis of disseminated tuberculosis, including hepatic involvemnt, was ultimately confirmed through biopsy. Subsequent anti-tuberculosis treatment resulted in marked clinical improvement. A literature review, complemented by this case, identified 82 similar patients, with an average age of 39.3 years (1-59 years old), predominantly presenting with fever. Diagnosis was generally established via imaging, culture of lesion pus, or biopsy , and the prognosis post anti-tuberculosis treatment was favorable. Conclusion Hepatic tuberculosis represents an uncommon manifestion of extrapulmonary tuberculosis, characterized by non-specific clinical symptoms, complicating its timely diagnosis. The reliance on imaging techniques and pathological biopsies is crucial for accurate identification. Early detection plays a pivotal role in the management of this condiion. In patient with an allergic constitution, like the case in point, the judicious selection of suitable anti-tuberculosis medications is pivotal for treatment efficay and patient recovery.

Key words: Fever of unknown origin, Hepatic tuberculosis, Lymphadenopathy

CHENG Qi, ZHOU Xian, JIANG Wei-min. Disseminated tuberculosis involving liver and lymph nodes: a case report and review of the literatures[J]. Chinese Hepatolgy, 2024, 29(4): 464-467.

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