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Intestinal/Peritoneal tuberculosis in children: an analysis of autopsy cases.

Ridaura-Sanz C, López-Corella E, Lopez-Ridaura R - Tuberc Res Treat (2012)

Bottom Line: Infection by Mycobacterium bovis is not infrequently identified in Mexico.Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract.The clinical differentiation of these conditions is difficult.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Institute of Pediatrics, 04530 Mexico City, DF, Mexico.

ABSTRACT
Infection by Mycobacterium bovis is not infrequently identified in Mexico. Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract. The term "abdominal tuberculosis" includes peritoneal as well as primary and secondary intestinal tuberculosis. The clinical differentiation of these conditions is difficult. In this work, we reviewed the clinical and pathological features of 24 cases of children dying with tuberculosis in whom autopsy revealed abdominal disease in a referral hospital in Mexico City. We identified 8 cases of primary intestinal tuberculosis, with documentation of M. bovis in 6 of them, and 9 cases of secondary intestinal tuberculosis (primary pulmonary disease), all negative to M. bovis. Seven patients had peritoneal tuberculosis without intestinal lesions and with active pulmonary disease in 4 of them, and of the remaining three, two had mesenteric lymph node involvement suggesting healed intestinal disease. In this approach to abdominal tuberculosis, postmortem analysis was able to differentiate primary from secondary intestinal tuberculosis and to define the nature of peritoneal involvement. This discrimination gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified.

No MeSH data available.


Related in: MedlinePlus

Mesenteric tuberculosis. Massive involvement of mesenteric lymph nodes with extensive caseation.
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Related In: Results  -  Collection


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fig5: Mesenteric tuberculosis. Massive involvement of mesenteric lymph nodes with extensive caseation.

Mentions: A correct clinical diagnosis of intestinal tuberculoses was achieved in all our primary cases but in only 5 of the 9 cases with the secondary form. In general, the cases with secondary forms were not seen by gastroenterologists, and the necessary diagnostic procedures were not considered. In contrast, in three of our primary cases, exploratory laparotomies were performed and biopsies taken. The main gastrointestinal clinical manifestations were abdominal pain (100%), diarrhea (76%), ascites (70%), and a palpable abdominal mass (59%). Gastrointestinal tract bleeding appeared more often in the secondary form and intestinal obstruction in the primary form.


Intestinal/Peritoneal tuberculosis in children: an analysis of autopsy cases.

Ridaura-Sanz C, López-Corella E, Lopez-Ridaura R - Tuberc Res Treat (2012)

Mesenteric tuberculosis. Massive involvement of mesenteric lymph nodes with extensive caseation.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539372&req=5

fig5: Mesenteric tuberculosis. Massive involvement of mesenteric lymph nodes with extensive caseation.
Mentions: A correct clinical diagnosis of intestinal tuberculoses was achieved in all our primary cases but in only 5 of the 9 cases with the secondary form. In general, the cases with secondary forms were not seen by gastroenterologists, and the necessary diagnostic procedures were not considered. In contrast, in three of our primary cases, exploratory laparotomies were performed and biopsies taken. The main gastrointestinal clinical manifestations were abdominal pain (100%), diarrhea (76%), ascites (70%), and a palpable abdominal mass (59%). Gastrointestinal tract bleeding appeared more often in the secondary form and intestinal obstruction in the primary form.

Bottom Line: Infection by Mycobacterium bovis is not infrequently identified in Mexico.Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract.The clinical differentiation of these conditions is difficult.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Institute of Pediatrics, 04530 Mexico City, DF, Mexico.

ABSTRACT
Infection by Mycobacterium bovis is not infrequently identified in Mexico. Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract. The term "abdominal tuberculosis" includes peritoneal as well as primary and secondary intestinal tuberculosis. The clinical differentiation of these conditions is difficult. In this work, we reviewed the clinical and pathological features of 24 cases of children dying with tuberculosis in whom autopsy revealed abdominal disease in a referral hospital in Mexico City. We identified 8 cases of primary intestinal tuberculosis, with documentation of M. bovis in 6 of them, and 9 cases of secondary intestinal tuberculosis (primary pulmonary disease), all negative to M. bovis. Seven patients had peritoneal tuberculosis without intestinal lesions and with active pulmonary disease in 4 of them, and of the remaining three, two had mesenteric lymph node involvement suggesting healed intestinal disease. In this approach to abdominal tuberculosis, postmortem analysis was able to differentiate primary from secondary intestinal tuberculosis and to define the nature of peritoneal involvement. This discrimination gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified.

No MeSH data available.


Related in: MedlinePlus