title: Abdominal and pericardial ultrasound in suspected extrapulmonary or disseminated tuberculosis.
abstract: OBJECTIVE
  Tuberculosis (TB) in patients with or without advanced HIV infection may present as smear-negative, extrapulmonary and/or disseminated forms. We studied the role of pericardial and abdominal ultrasound examinations in the determination of extrapulmonary or disseminated TB.
  
  
  METHODS
  A prospective descriptive and analytic cross-sectional study design was used to determine the ultrasound findings of value in patients with subsequently proven TB. Ultrasound examinations were performed on 300 patients admitted to G F Jooste Hospital with suspected extrapulmonary or disseminated TB.
  
  
  METHODS
  The presence of hepatomegaly, splenomegaly, lymphadenopathy (location, size and appearance), ascites, pleural effusions, pericardial effusions and/or splenic micro-abscesses was noted. Clinical findings, microbiological and serological data were also recorded, correlated and analysed.
  
  
  RESULTS
  Complete data sets were available for 267 patients; 91.0% were HIV positive, and 70.0% had World Health Organization clinical stage 4 disease. Active TB (determined by smear or culture) was present in 170 cases (63.7%). Ultrasonically visible abdominal lymphadenopathy over 1 cm in minimum diameter correlated with active TB in 55.3% of cases (odds ratio (OR) 2.6, 95% confidence interval (CI) 1.5 - 4.6, p = 0.0002). Ultrasonographically detected pericardial effusions (OR 2.8, 95% CI 1.6 - 5.0, p < 0.0001), ascites (OR 2.2, 95% CI 1.2 - 4.2, p = 0.005) and splenic lesions (OR 1.9, 95% CI 1.0 - 3.5, p = 0.024) also predicted active TB.
  
  
  CONCLUSIONS
  Pericardial and abdominal ultrasound examinations are valuable supplementary investigations in the diagnosis of suspected extrapulmonary or disseminated TB.
authors.affiliation: Department of Radiology, G F Jooste Hospital and University of Cape Town. mpfiles@iafrica.com
authors.forename: Maya Nathu
authors.initials: MN
authors.lastname: Patel
authors.forename: Stephen
authors.initials: S
authors.lastname: Beningfield
authors.forename: Vanessa
authors.initials: V
authors.lastname: Burch
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014376:Tuberculosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography