Cargando…

Tuberculous appendicitis: A review of reported cases over the past 10 years

BACKGROUND: Tuberculous appendicitis is a rare extrapulmonary manifestation of tuberculosis without clear summarization or consensus on its management. DATA SOURCES: Case reports were gathered from several online literature databases by searching terms “tuberculosis”, “tuberculous”, and “appendiciti...

Descripción completa

Detalles Bibliográficos
Autores principales: Hubbard, Grant, Chlysta, Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053796/
https://www.ncbi.nlm.nih.gov/pubmed/33898762
http://dx.doi.org/10.1016/j.jctube.2021.100228
_version_ 1783680189865132032
author Hubbard, Grant
Chlysta, Walter
author_facet Hubbard, Grant
Chlysta, Walter
author_sort Hubbard, Grant
collection PubMed
description BACKGROUND: Tuberculous appendicitis is a rare extrapulmonary manifestation of tuberculosis without clear summarization or consensus on its management. DATA SOURCES: Case reports were gathered from several online literature databases by searching terms “tuberculosis”, “tuberculous”, and “appendicitis”. Report eligibility criteria: Cases of appendicitis due to M. tuberculosis identified on operative histology. Exclusion criteria: appendicitis caused by a mycobacterium other than M. tuberculosis, and appendiceal tuberculosis identified incidentally during procedures for other reasons. RESULTS: Thirty four patients were identified. Twenty five patients presented with acute right lower quadrant abdominal pain. Eleven patients described chronic symptoms of tuberculosis (cough, night sweats, or weakness/fatigue). Four patients had a known diagnosis of TB. Seven of 24 cases reported peri-operative chest imaging which demonstrated pulmonary lesions. AFB were present in tissue or fluid samples of 6 patients, and negative in 15 patients. All patients underwent pharmacotherapy on a WHO-recommended anti-tuberculous treatment (ATT) with RIPE or an alternative. The average duration of treatment was 7.2 ± 1.7 months. LIMITATIONS: Data was gathered from case reports without complete uniformity in diagnostic work-up. The potential for larger scale study is limited due to disease rarity. CONCLUSIONS: Tuberculous appendicitis cannot be diagnosed prior to histologic evaluation. Several data points may suggest the disease on a clinician's differential diagnosis if they present with a combination of the following: born in a country with endemic tuberculosis; chronic cough, weakness/fatigue, or nausea prior to onset of abdominal pain; pulmonary lesions on chest X-ray; white studding of the mesentery or peritoneum in a young patient; positive AFB stain of abdominal fluid or peritoneal tissue.
format Online
Article
Text
id pubmed-8053796
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-80537962021-04-22 Tuberculous appendicitis: A review of reported cases over the past 10 years Hubbard, Grant Chlysta, Walter J Clin Tuberc Other Mycobact Dis Article BACKGROUND: Tuberculous appendicitis is a rare extrapulmonary manifestation of tuberculosis without clear summarization or consensus on its management. DATA SOURCES: Case reports were gathered from several online literature databases by searching terms “tuberculosis”, “tuberculous”, and “appendicitis”. Report eligibility criteria: Cases of appendicitis due to M. tuberculosis identified on operative histology. Exclusion criteria: appendicitis caused by a mycobacterium other than M. tuberculosis, and appendiceal tuberculosis identified incidentally during procedures for other reasons. RESULTS: Thirty four patients were identified. Twenty five patients presented with acute right lower quadrant abdominal pain. Eleven patients described chronic symptoms of tuberculosis (cough, night sweats, or weakness/fatigue). Four patients had a known diagnosis of TB. Seven of 24 cases reported peri-operative chest imaging which demonstrated pulmonary lesions. AFB were present in tissue or fluid samples of 6 patients, and negative in 15 patients. All patients underwent pharmacotherapy on a WHO-recommended anti-tuberculous treatment (ATT) with RIPE or an alternative. The average duration of treatment was 7.2 ± 1.7 months. LIMITATIONS: Data was gathered from case reports without complete uniformity in diagnostic work-up. The potential for larger scale study is limited due to disease rarity. CONCLUSIONS: Tuberculous appendicitis cannot be diagnosed prior to histologic evaluation. Several data points may suggest the disease on a clinician's differential diagnosis if they present with a combination of the following: born in a country with endemic tuberculosis; chronic cough, weakness/fatigue, or nausea prior to onset of abdominal pain; pulmonary lesions on chest X-ray; white studding of the mesentery or peritoneum in a young patient; positive AFB stain of abdominal fluid or peritoneal tissue. Elsevier 2021-03-18 /pmc/articles/PMC8053796/ /pubmed/33898762 http://dx.doi.org/10.1016/j.jctube.2021.100228 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Hubbard, Grant
Chlysta, Walter
Tuberculous appendicitis: A review of reported cases over the past 10 years
title Tuberculous appendicitis: A review of reported cases over the past 10 years
title_full Tuberculous appendicitis: A review of reported cases over the past 10 years
title_fullStr Tuberculous appendicitis: A review of reported cases over the past 10 years
title_full_unstemmed Tuberculous appendicitis: A review of reported cases over the past 10 years
title_short Tuberculous appendicitis: A review of reported cases over the past 10 years
title_sort tuberculous appendicitis: a review of reported cases over the past 10 years
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053796/
https://www.ncbi.nlm.nih.gov/pubmed/33898762
http://dx.doi.org/10.1016/j.jctube.2021.100228
work_keys_str_mv AT hubbardgrant tuberculousappendicitisareviewofreportedcasesoverthepast10years
AT chlystawalter tuberculousappendicitisareviewofreportedcasesoverthepast10years