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2010 | 5 | 5 | 573-576
Tytuł artykułu

Coexistence of pancreatic tuberculosis with systemic brucellosis: a case report

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Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Isolated pancreatic tuberculosis is an extremely rare clinical entity and is difficult to diagnose particularly in immunocompetent individuals. Clinical findings and symptomatology of brucellosis are often similar to tuberculosis thus making the differentiation amongst the two entities difficult. We report a case of pancreatic tuberculosis with systemic brucellosis in a 29 year old veterinarian who presented with epigastric pain and loss of appetite. Initial investigations revealed leukocytosis with moderately elevated transaminase, gamma glutamyl transferase, amylase and lipase levels. Imaging studies revealed an anechoic multiloculated cyst in the body and tail of the pancreas. Given the patient’s occupational risk coupled with the presence of a positive Brucella agglutination test (with a titer of 1:320); a diagnosis of pancreatitis secondary to brucellosis was given. In addition to standard pancreatitis therapy of bowel rest with intravenous fluid/electrolyte replacement, anti-brucellosis therapy was also administered. The patient’s initial response to therapy was positive however, 6 weeks into therapy, his abdominal pain recurred and repeat CT scan revealed the development of a pseudocyst in the pancreas. After failing a second attempt at conservative supportive therapy, the patient underwent an explorative laparotomy. Histological examination of the resected pancreatic specimen showed necrosis and was positive for tuberculosis by polymerase chain reaction. Herein, we describe the first case reported in the medical literature of the coexistence of systemic brucellosis with pancreatic tuberculosis. We suggest that the possibility of the coexistence of brucellosis with tuberculosis be kept in mind when assessing pancreatitis patients in endemic regions and in individuals with occupational risk hazards.
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Wydawca

Czasopismo
Rocznik
Tom
5
Numer
5
Strony
573-576
Opis fizyczny
Daty
wydano
2010-10-01
online
2010-08-20
Twórcy
autor
  • Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey, draliacar@yahoo.com
  • Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
autor
  • Department of Medical Microbiology, Gulhane Military Medical Academy Haydarpasa Training Hospital, Uskudar-Istanbul, 34668, Istanbul, Turkey
autor
  • Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
  • Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
autor
  • Acibadem Hospital, 34457, Istanbul, Turkey
autor
  • Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
  • Department of Infectious Disease and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34668, Istanbul, Turkey
Bibliografia
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  • [15] Jenney A.W., Pickles R.W., Hellard M.E., Spelman D.W., Fuller A.J., Spicer W.J., Tuberculosis pancreatic abscess in an HIV negative patient: case report and review, Scand. J. Infect. Dis., 1998, 30, 99–104 http://dx.doi.org/10.1080/003655498750003438[Crossref]
  • [16] Suri R., Gupta S., Gupta S.K., Singh K., Suri S., Ultrasound guided fine needle aspiration cytology in abdominal tuberculosis, Br. J. Radiol., 1998, 71, 723–7
  • [17] Mantur B.G., Amarnath S.K., Shinde R.S., Review of clinical and laboratory features of human brucellosis. Indian. J. Med. Microbiol., 2007, 25, 188–202 http://dx.doi.org/10.4103/0255-0857.34758[Crossref]
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Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-009-0143-1
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