American Journal of Medical Case Reports. 2014, 2(12), 288-290
DOI: 10.12691/AJMCR-2-12-8
Intrathoracic and Intraabdominal Tuberculosis Lymphadenitis without Lung Involvement in an Immunocompetent Patient
Qiyuan Dai1, , Jia Qin2 and Mohamed Abdulla3
1Department of Medicine, SUNY Downstate Medical Center, New York, United States
2Department of Pathology, SUNY Downstate Medical Center, New York, United States
3Department of Pathology, Kings County Hospital Center, New York, United States
Pub. Date: December 11, 2014
Cite this paper
Qiyuan Dai, Jia Qin and Mohamed Abdulla. Intrathoracic and Intraabdominal Tuberculosis Lymphadenitis without Lung Involvement in an Immunocompetent Patient.
American Journal of Medical Case Reports. 2014; 2(12):288-290. doi: 10.12691/AJMCR-2-12-8
Abstract
Extrapulmonary tuberculosis (EPTB) is defined as tuberculosis (TB) affecting organs other than lung. The most common site of EPTB is the lymph node. In adults, lymphadenopathy without a lung parenchymal infiltrate is rare and is usually observed in immunocompromised patients. We report a case of a 53 years old non-immunocompromised women from affected by intrathoracic and intraabdominal tuberculosis lymphadenitis without lung involvement. The patient presented with subacute fever, night sweat, fatigue, anorexia, abdominal pain, and weight loss. The diagnosis was made by the combination of computed tomography (CT) scans and histopathology studies. CT scans showed multiple lymph nodes involvement in the mediastinal and abdominal areas. Histopathology studies showed necrotizing lymphadenitis with positive acid-fast bacilli stain. The patient responded to (rifampin, isoniazid, pyrazinamide, ethambutol) therapy well and was discharged five days after initiating the treatment.
Keywords
tuberculosis, lymphadenitis, immunocompetent
Copyright
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References
[1] | Corbett EL, Watt CJ, Walker N, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Archives of internal medicine 2003; 163: 1009-21. |
|
[2] | Daley CL, Small PM, Schecter GF, et al. An outbreak of tuberculosis with accelerated progression among persons infected with the human immunodeficiency virus. An analysis using restriction-fragment-length polymorphisms. The New England journal of medicine 1992; 326: 231-5. |
|
[3] | Havlir DV, Barnes PF. Tuberculosis in patients with human immunodeficiency virus infection. The New England journal of medicine 1999; 340: 367-73. |
|
[4] | Selwyn PA, Hartel D, Lewis VA, et al. A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. The New England journal of medicine 1989; 320: 545-50. |
|
[5] | Sharma SK, Mohan A. Extrapulmonary tuberculosis. The Indian journal of medical research 2004; 120: 316-53. |
|
[6] | Lee KS, Song KS, Lim TH, Kim PN, Kim IY, Lee BH. Adult-onset pulmonary tuberculosis: findings on chest radiographs and CT scans. AJR American journal of roentgenology 1993; 160: 753-8. |
|
[7] | Pirina P, Spada V, Santoru L, et al. Chest tuberculosis with mediastinal asymptomatic lymphadenitis without lung involvement in an immunocompetent patient. Journal of infection in developing countries 2013; 7: 280-5. |
|
[8] | Appling D MH. Mycobacterial cervical lymphadenopathy: 1981 update.. Laryngoscope 1981; 91. |
|
[9] | Thompson MM, Underwood MJ, Sayers RD, Dookeran KA, Bell PR. Peripheral tuberculous lymphadenopathy: a review of 67 cases. The British journal of surgery 1992; 79: 763-4. |
|
[10] | Bem C. Human immunodeficiency virus-positive tuberculous lymphadenitis in Central Africa: clinical presentation of 157 cases. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 1997; 1: 215-9. |
|
[11] | Dandapat MC, Mishra BM, Dash SP, Kar PK. Peripheral lymph node tuberculosis: a review of 80 cases. The British journal of surgery 1990; 77: 911-2. |
|
[12] | Subrahmanyam M. Role of surgery and chemotherapy for peripheral lymph node tuberculosis. The British journal of surgery 1993; 80: 1547-8. |
|
[13] | Silva DR, Menegotto DM, Schulz LF, Gazzana MB, Dalcin Pde T. Clinical characteristics and evolution of non-HIV-infected immunocompromised patients with an in-hospital diagnosis of tuberculosis. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia 2010; 36: 475-84. |
|