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Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer

Tuberculosis is a disease with serious consequences in terms of morbidity and mortality. Pancreatic localization is very rare and is mostly encountered in patients with immunosuppressive disorders. A 59-year-old woman with arterial hypertension, grade 2 obesity, and a history of cholecystectomy, was...

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Autores principales: Diaconu, Camelia Cristina, Gheorghe, Gina, Hortopan, Andreea, Enache, Valentin, Ceobanu, Gabriela, Jinga, Viorel, Adrian, Cosmin, Ionescu, Vlad-Alexandru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505864/
https://www.ncbi.nlm.nih.gov/pubmed/36143842
http://dx.doi.org/10.3390/medicina58091165
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author Diaconu, Camelia Cristina
Gheorghe, Gina
Hortopan, Andreea
Enache, Valentin
Ceobanu, Gabriela
Jinga, Viorel
Adrian, Cosmin
Ionescu, Vlad-Alexandru
author_facet Diaconu, Camelia Cristina
Gheorghe, Gina
Hortopan, Andreea
Enache, Valentin
Ceobanu, Gabriela
Jinga, Viorel
Adrian, Cosmin
Ionescu, Vlad-Alexandru
author_sort Diaconu, Camelia Cristina
collection PubMed
description Tuberculosis is a disease with serious consequences in terms of morbidity and mortality. Pancreatic localization is very rare and is mostly encountered in patients with immunosuppressive disorders. A 59-year-old woman with arterial hypertension, grade 2 obesity, and a history of cholecystectomy, was admitted for fever (38.5 °C), jaundice, and marked physical asthenia. The blood tests showed severe metabolic acidosis, with partial respiratory compensation, mild microcytic normochromic anemia, inflammatory syndrome, procalcitonin value ten times the upper limit of normal, nitrogen retention syndrome, hypoalbuminemia, hypertriglyceridemia, hypercholesterolemia, and moderate hyponatremia. The electrocardiogram, chest X-ray, and abdominal ultrasound did not show any significant pathological changes. Contrast-enhanced computed tomography raised the suspicion of acute-on-chronic pancreatitis and subsequent evaluation by magnetic resonance imaging raised the suspicion of a pancreatic tumor. Pancreatic fine needle biopsy under echoendoscopic guidance revealed purulent material, which was sent for cytological and bacteriological examination. The Ziehl-Neelsen stain showed acid-alcoholic resistant bacilli, while bacterial cultures were positive for gentamicin and tigecycline-sensitive Klebsiella. The diagnosis of pancreatic tuberculosis was established. Pancreatic tuberculosis is a very rare condition that often mimics pancreatic cancer. The peculiarity of the case is the appearance of pancreatic tuberculosis in an immunocompetent woman and the association with Klebsiella infection.
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spelling pubmed-95058642022-09-24 Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer Diaconu, Camelia Cristina Gheorghe, Gina Hortopan, Andreea Enache, Valentin Ceobanu, Gabriela Jinga, Viorel Adrian, Cosmin Ionescu, Vlad-Alexandru Medicina (Kaunas) Case Report Tuberculosis is a disease with serious consequences in terms of morbidity and mortality. Pancreatic localization is very rare and is mostly encountered in patients with immunosuppressive disorders. A 59-year-old woman with arterial hypertension, grade 2 obesity, and a history of cholecystectomy, was admitted for fever (38.5 °C), jaundice, and marked physical asthenia. The blood tests showed severe metabolic acidosis, with partial respiratory compensation, mild microcytic normochromic anemia, inflammatory syndrome, procalcitonin value ten times the upper limit of normal, nitrogen retention syndrome, hypoalbuminemia, hypertriglyceridemia, hypercholesterolemia, and moderate hyponatremia. The electrocardiogram, chest X-ray, and abdominal ultrasound did not show any significant pathological changes. Contrast-enhanced computed tomography raised the suspicion of acute-on-chronic pancreatitis and subsequent evaluation by magnetic resonance imaging raised the suspicion of a pancreatic tumor. Pancreatic fine needle biopsy under echoendoscopic guidance revealed purulent material, which was sent for cytological and bacteriological examination. The Ziehl-Neelsen stain showed acid-alcoholic resistant bacilli, while bacterial cultures were positive for gentamicin and tigecycline-sensitive Klebsiella. The diagnosis of pancreatic tuberculosis was established. Pancreatic tuberculosis is a very rare condition that often mimics pancreatic cancer. The peculiarity of the case is the appearance of pancreatic tuberculosis in an immunocompetent woman and the association with Klebsiella infection. MDPI 2022-08-27 /pmc/articles/PMC9505864/ /pubmed/36143842 http://dx.doi.org/10.3390/medicina58091165 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Diaconu, Camelia Cristina
Gheorghe, Gina
Hortopan, Andreea
Enache, Valentin
Ceobanu, Gabriela
Jinga, Viorel
Adrian, Cosmin
Ionescu, Vlad-Alexandru
Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title_full Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title_fullStr Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title_full_unstemmed Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title_short Pancreatic Tuberculosis—A Condition That Mimics Pancreatic Cancer
title_sort pancreatic tuberculosis—a condition that mimics pancreatic cancer
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9505864/
https://www.ncbi.nlm.nih.gov/pubmed/36143842
http://dx.doi.org/10.3390/medicina58091165
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