title: Abdominal tuberculosis in a low prevalence country.
abstract: OBJECTIVE
  Abdominal tuberculosis is a rare disease. The clinical and radiological manifestations are non-specific and the diagnosis is difficult. Our objective was to describe the characteristics and treatment of patients presenting with abdominal tuberculosis in a low-incidence country.
  
  
  METHODS
  We reviewed the clinical, diagnostic, treatment, and outcome features of patients presenting with abdominal tuberculosis diagnosed by bacteriological and/or histological results and managed in five French university hospitals from January 2000 to December 2009.
  
  
  RESULTS
  We included 21 patients. The mean diagnostic delay was 13 months. Twelve patients (57%) came from a low-incidence area and only two had a known immunosuppressed condition. Eighteen patients (86%) presented with abdominal symptoms. The main organs involved were the peritoneum (n=14, 66%), the mesenteric lymph nodes (n=13, 62%), and the bowel (n=7, 33%). Sixteen patients (76%) underwent surgery, including two in an emergency setting. Seventeen patients (81%) received six months or more of anti-tuberculosis treatment. Finally, 16 patients (76%) had a positive outcome.
  
  
  CONCLUSIONS
  New diagnostic procedures, and especially molecular biology, may help diagnose unusual clinical presentations of tuberculosis. Invasive procedures are frequently necessary to obtain samples but also for the treatment of digestive involvement.
authors.affiliation: Infectious Diseases Department, University Hospital of Dijon, BP 97908, 21000 Dijon, France. Electronic address: aurelie.fillion@ch-chalon71.fr.
authors.forename: A
authors.initials: A
authors.lastname: Fillion
authors.affiliation: Digestive and Surgical Oncology Department, University Hospital of Dijon, BP 97908, 21000 Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Ortega-Deballon
authors.affiliation: Digestive and Surgical Oncology Department, University Hospital of Dijon, BP 97908, 21000 Dijon, France.
authors.forename: S
authors.initials: S
authors.lastname: Al-Samman
authors.affiliation: Department of Pneumology, University Hospital of Grenoble, CS 10217, 38043 Grenoble cedex 09, France.
authors.forename: A
authors.initials: A
authors.lastname: Briault
authors.affiliation: Department of Digestive Surgery, University Hospital of Strasbourg, 67098 Strasbourg, France.
authors.forename: C
authors.initials: C
authors.lastname: Brigand
authors.affiliation: Department of Digestive Surgery, University Hospital of Reims, Robert-Debré Hospital, avenue General-Koening, 51092 Reims cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Deguelte
authors.affiliation: Department of Digestive, Hepatobiliary, and Endocrine Surgery, University Hospital of Nancy, Hôpitaux de Brabois, bâtiment Philippe-Canton, allée du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Germain
authors.affiliation: Infectious Disease Department, University Hospital of Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Hansmann
authors.affiliation: Department of Digestive Surgery, University Hospital of Lyon, Hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Pelascini
authors.affiliation: Infectious Diseases Department, University Hospital of Nancy, Hôpitaux de Brabois, bâtiment Philippe-Canton, allée du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Rabaud
authors.affiliation: Infectious Diseases Department, University Hospital of Dijon, BP 97908, 21000 Dijon, France.
authors.forename: P
authors.initials: P
authors.lastname: Chavanet
authors.affiliation: Infectious Diseases Department, University Hospital of Dijon, BP 97908, 21000 Dijon, France.
authors.forename: L
authors.initials: L
authors.lastname: Piroth
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D001208:Asia / Q000208:ethnology; D057210:Delayed Diagnosis; D054242:Emigrants and Immigrants; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D059425:Interferon-gamma Release Tests; D008297:Male; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D063189:Symptom Assessment; D016896:Treatment Outcome; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D014386:Tuberculosis, Hepatic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Adénopathies mésentériques; Mesenteric lymphadenitis; Peritonitis; Péritonite; Tuberculose; Tuberculosis