A tumor-like manifestation of extrapulmonary tuberculosis in a hemodialysis patient.
Though pulmonary tuberculosis (TBC) remains the commonest clinical presentation, extrapulmonary TBC is an increasingly important clinical problem. Among the extrapulmonary sites, primary liver tuberculosis seems to be an extremely rare location. Fewer than 100 cases of TBC hepatic abscesses have been reported whereas most of them have been originated from other sites, usually the lung and the gastrointestinal track. Therefore, in the absence of any particular symptom this infrequent location may lead to a delayed or missing diagnosis. The present study reports the difficulties in early diagnosis of an extrapulmonary TBC case, as it happened to a 53-year-old man with diabetic nephropathy who started on regular hemodialysis for 5 months. In such "atypical presentations" the clinicians should bear in their mind the possibility of the TBC occurrence, which usually responds well to the conventional antituberculous therapy.
Kriki
P
P
Department of Nephrology, and 2Department of Radiology, Medical School, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, Alexandroupolis, Greece.
Thodis
E
E
Deftereos
S
S
Panagoutsos
S
S
Theodoridis
M
M
Kantartzi
K
K
Mourvati
E
E
Prassopoulos
P
P
Passadakis
P
P
Vargemezis
V
V
D003928:Diabetic Nephropathies / Q000150:complications* / Q000628:therapy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008099:Liver / Q000382:microbiology / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011718:Pyrazinamide / Q000627:therapeutic use; D006435:Renal Dialysis; D012293:Rifampin / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014386:Tuberculosis, Hepatic / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin