Hepatic tuberculosis: Difference between revisions

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(Created page with "== Background == * Infection of the liver by Mycobacterium tuberculosis == Clinical Manifestations == * Most commonly presents with hepatomegaly and fever * Also respiratory symptoms, abdominal pain, and weight loss are common * Elevated ALP and GGT == Diagnosis == * Poor sensitivity of liver biopsy showing AFB and growing tuberculosis, but PCR often positive * Histology usually shows caseating granuloma == Management == * As per other forms of Mycobacterium...")
 
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* Infection of the liver by [[Mycobacterium tuberculosis]]
 
* Infection of the liver by [[Mycobacterium tuberculosis]]
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* Occurs in about 1% of all cases of TB, but likely more common in miliary disease and those with more severe pulmonary disease
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* More common than hepatic [[tuberculoma]]
   
 
== Clinical Manifestations ==
 
== Clinical Manifestations ==
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* Most commonly presents with hepatomegaly and fever
 
* Most commonly presents with hepatomegaly and fever
 
* Also respiratory symptoms, abdominal pain, and weight loss are common
 
* Also respiratory symptoms, abdominal pain, and weight loss are common
* Elevated ALP and GGT
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* Elevated ALP and GGT common; only occasional ALT and AST elevation
   
 
== Diagnosis ==
 
== Diagnosis ==
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* As per other forms of [[Mycobacterium tuberculosis#Management|Mycobacterium tuberculosis]], duration of 6 to 12 months
 
* As per other forms of [[Mycobacterium tuberculosis#Management|Mycobacterium tuberculosis]], duration of 6 to 12 months
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== Further Reading ==
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* 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: [https://doi.org/10.1186%2Fs12879-015-0944-6 10.1186/s12879-015-0944-6]. PMID: [https://pubmed.ncbi.nlm.nih.gov/25943103 25943103]; PMCID: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425874/ PMC4425874].
   
 
[[Category:Tuberculosis]]
 
[[Category:Tuberculosis]]

Latest revision as of 15:34, 13 June 2023

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.