title: Abdominal tuberculosis in adult: 10-year experience in a teaching hospital in central Taiwan.
abstract: OBJECTIVE
  Tuberculosis (TB) is an important communicable disease worldwide. The clinical presentation of abdominal TB often mimics various gastrointestinal disorders and may delay accurate diagnosis. In this study, we conducted a 10-year retrospective study to investigate the clinical manifestations, treatment responses and outcomes of abdominal TB.
  
  
  METHODS
  This retrospective study recruited patients presenting between January 1998 and December 2007; all patients ≥ 18 years of age with a diagnosis of abdominal TB were enrolled. Patient charts were thoroughly reviewed and clinical specimens were processed in the laboratory using the BBL MycoPrep System and BACTEC MGIT 960 Mycobacterial Detection System. Mycobacterium tuberculosis complex was confirmed by acid fast stain and the BD ProbeTec ET System.
  
  
  RESULTS
  During the study period, 34 patients were diagnosed with abdominal TB. The mean age was 55+18 years. Fourteen patients (41%) had no risk factors; however, 20 patients (59%) had at least one risk factor. Abdominal pain (94.1%), abdominal fullness (91.2%), anorexia (88.2%) and ascites (76.5%) were the most common presenting symptoms. The peritoneum (88%) was the most commonly involved site. Patients with risk factors such as liver cirrhosis, end-stage renal disease and diabetes mellitus had a higher positive rate of acid-fast stain and mycobacterial culture from abdominal specimens (p = 0.02 and 0.05, respectively). The crude mortality rate was 9% and the attributed mortality rate was 3%.
  
  
  CONCLUSIONS
  In an endemic area like Taiwan, regardless of whether a patient has risk factors for TB, abdominal TB should be seriously considered as a differential diagnosis when a patient presents with gastrointestinal symptoms and unexplained ascites.
authors.affiliation: Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Huei
authors.initials: CH
authors.lastname: Chou
authors.forename: Mao-Wang
authors.initials: MW
authors.lastname: Ho
authors.forename: Cheng-Mao
authors.initials: CM
authors.lastname: Ho
authors.forename: Po-Chang
authors.initials: PC
authors.lastname: Lin
authors.forename: Chin-Yun
authors.initials: CY
authors.lastname: Weng
authors.forename: Tsung-Chia
authors.initials: TC
authors.lastname: Chen
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Chi
authors.forename: Jen-Hsian
authors.initials: JH
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000382:microbiology; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult