Retrospective Evaluation Of Pediatric Patients With Abdominal Tuberculosis: A Single Center Experience

Abstract

Objective: Abdominal tuberculosis is a kind of extrapulmonary tuberculosis that can usually occur during the lymphohematogenous spread of first Mycobacterium tuberculosis infection, develop by neighborhood from an abdominal focus or a mesenteric lymph node. The aim of this study is to evaluate pediatric cases diagnosed with abdominal tuberculosis. Material and Methods: Between 2012-2018, seven patients diagnosed with abdominal tuberculosis through patients who diagnosed with extrapulmonary tuberculosis in our hospital, were included in study. Demographic and clinical characteristics, diagnostic methods, commenced treatments and clinical follow up of patients were listed from medical records. Results: Of patients, four were female. The mean age was 144.2 ± 42.7 months. None of the patients had a history of tuberculosis contact. The median complaint time was 20 days (5-180). The most frequent complaint was abdominal pain and the most frequent physical examination finding was abdominal tenderness. Mean white blood cell count was 9.26 x 103 ± 4.77 x 103 μ/L, C reactive protein level: 79.9 ± 54.9 mg/dL, erytrocyte sedimentation rate: 45 ± 30 mm/h. Tuberculin skin test was positive in two patients, interferon gamma releasing assay was positive in three patients, and in two patients, both tests were positive. There were findings suggesting tuberculosis on pulmonary imaging in five patients and abdominal imaging in all patients. Histopathological examination of the specimens of six patients revealed findings consistent with tuberculosis. The presence of M. tuberculosis was confirmed microbiologically in clinical specimens taken from three patients. The most common abdominal tuberculosis type was mesenteric lymphadenitis. The mean time from admission to diagnosis was 15 ± 12.8 days. All patients recieved antituberculosis treatment. Conclusion: Abdominal tuberculosis should be kept in mind, in patients presenting with abdominal complaints lasting more than five days. Ultrasonography and computed tomography are useful to determine abdominal tuberculosis type. The disease can be sucsessfully treated with standart antituberculosis treatment.