Karaciğer tuberkülozu: bir olgu sunumu

Year 2012, Volume: 9 Issue: 2, 79 - 81, 01.08.2012

Hasan Cece Mahmut Abuhandan Ekrem Karakas Sema Yıldız Mustafa Calik

Abstract

Tuberküloz Türkiye'de önemli bir halk sağlığı sorunudur. Bununla birlikte karaciğer tutulumu nadirdir. Hastalık sıklıkla sebebi bilinmeyen ateş bulgusu ile ortaya çıkabilir. Sekiz aylık bir erkek çocuk huzursuzluk, yüksek ateş, kilo kaybı ve emmeyi reddetme şikâyeti ile başvurdu. Özellikle akciğer dışı tuberkülozlu hastaların kliniğinin belirsiz olmasından dolayı karaciğer tuberkülozunun tanısını koymak zordur. Karaciğer tuberkülomunun klinik ve radyolojik bulguları düşük özgüllükte olup histopatolojik ve bakteriyolojik kültür tanısı gereklidir. Bizim olgumuzda hepatik tuberkülozun tanısı karaciğer nodülünün histopatolojik muayenesi ile konuldu. Bu makalede akciğer dışı tuberkülozun nadir görülen formlarından karaciğer tuberkülozunu sunduk

Keywords

Karaciğer, tüberküloz, çocuk

Liver tuberculosis: report of a case

Abstract

Tuberculosis is a very important public health problem in Turkey. However, tubercular involvement of the liver is uncommon. Occasionally, the illness might present as fever of unknown origin. An 8-month-old male infant presented with irritability and high fever, restlessness no weight gain, and refusal of breast milk. The establishment of a diagnosis of liver tuberculosis is difficult, particularly because of the obscure extrapulmonary features of tuberculosis. Clinical and radiological findings of liver tuberculoma are of low specificity, and histopathological plus bacteriological confirmation is necessary. In our case, the diagnosis of hepatic tuberculosis was established via histopathological examination of a hepatic nodule. In this manuscript, we presented a case with hepatic tuberculosis since this is a rare extrapulmonary manifestation of tuberculosis

Keywords

Liver, tuberculosis, child

References

• Leader SA. Tuberculosis of the liver and gall- bladder with abscess formation: a review and case report. Ann Intern Med 1952; 37: 594–606.
• Chien RN, Lin PY, Liaw YF. Hepatic tuberculosis: comparison of miliary and local form. Infection ; 23: 5–12. Hersch C. Tuberculosis of the liver: a study of 200 cases. S Afr Med 1964; 38: 857-63.
• Reed DH, Nash AF, Valabhji P. Radiological diagnosis and management of a solitary tuberculous hepatic abscess. Br J Radiol 1990; 63: –4.
• Mert A, Ozaras R, Tabak F, et al. Localized hepatic tuberculosis. Eur J Intern Med 2003; 14: 2.
• Tritou I, Prassopoulos P, Daskalogiannaki M, et al. Miliary hepatic tuberculosis not associated with splenic or lung involvement. Acta Radiol 2000; 41: 81
• Kok KYY, Yapp SKS. Isolated hepatic tuberculosis: report of five cases and review of the literature. J Hepatobiliary Pancreat Surg 1999; 6: 8
• Kubota H, Ageta M, Kubo H, Wada S, Nagamachi S, Yamanaka T. Tuberculous liver abscess treated by percutaneous infusion of antituberculous agents. Intern Med 1994; 33: 351–356.
• Bernhard JS, Bhatia G, Knauer CM. Gastrointestinal tuberculosis: an eighteen-patient experience and review. J Clin Gastroentrol 2000; 30: 402.
• Tan TC, Cheung AY, Wan WY, Chen TC. Tuberculoma of the liver presenting as a hyperechoic mass on ultrasound. Br J Radiol 1997; 70: 1293–5.
• Patanakar T, Prasad S, Armao D, Mukherji SK. Tuberculous abscesses of the liver. Am J Roentgenol ; 174: 1166–7.
• Caramella T, Fuerxer F, Chevallier P, et al. MR features of hepatic macronodular Mycobacteriosis. J Radiol 2007; 88: 47-51.
• Hayashi M, Yamawaki I, Okajima K, Tomimatsu M, Ohkawa S. Tuberculous liver abscess not associated with lung involvement. Intern Med. 2004; 43: 521-3.