Hepatic tuberculosis

From IDWiki

Background

  • Infection of the liver by Mycobacterium tuberculosis
  • Occurs in about 1% of all cases of TB, but likely more common in miliary disease and those with more severe pulmonary disease
  • More common than hepatic tuberculoma

Clinical Manifestations

  • Most commonly presents with hepatomegaly and fever
  • Also respiratory symptoms, abdominal pain, and weight loss are common
  • Elevated ALP and GGT common; only occasional ALT and AST elevation

Diagnosis

  • Poor sensitivity of liver biopsy showing AFB and growing tuberculosis, but PCR often positive
  • Histology usually shows caseating granuloma

Management

Further Reading

  • Hickey AJ, Gounder L, Moosa MY, Drain PK. A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection. BMC Infect Dis. 2015 May 6;15:209. doi: 10.1186/s12879-015-0944-6. PMID: 25943103; PMCID: PMC4425874.