rifampin and Tuberculosis--Hepatic

Tuberculous liver abscess has been reported in only fourteen patients in Japan and in twenty-nine patients outside Japan. Only nine of the non-Japanese patients and none of the Japanese patients have been treated for this condition without laparotomy. We report a patient who developed tuberculous liver abscess during treatment of tuberculous peritonitis. Diagnosis was made by ultrasound-guided aspiration biopsy, and the patient was treated with percutaneous drainage and transcatheter infusion of antituberculous agents. Direct infusion of antituberculous agents has more direct effects in the treatment of an abscess than systemic chemotherapy alone. Therefore, if a percutaneous catheter can be safely placed, the use of transcatheter infusion of antituberculous agents should be considered.

Topics: Administration, Cutaneous; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Female; Humans; Isoniazid; Liver Abscess; Middle Aged; Peritonitis, Tuberculous; Rifampin; Tuberculosis, Hepatic

Tuberculosis caused by Mycobacterium tuberculosis presents a major health challenge in endemic countries and spares no organ in the human body. This infection is a mimicker of various disease processes such as metastasis, lymphoproliferative diseases, and other granulomatous conditions such as sarcoidosis and fungal infections. The most challenging and important differential is metastasis, especially in the disseminated form of tuberculosis. We present a histopathologically proven case of isolated hepatosplenic tuberculosis that was provisionally diagnosed as lymphoma due to its unusual, restricted involvement of the liver and spleen.

Topics: Abdominal Pain; Antitubercular Agents; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Middle Aged; Pyrazinamide; Rifampin; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Hepatic; Tuberculosis, Splenic; Weight Loss

Tuberculosis (TB) remains the "great pretender." We report the case of a 10-year-old female, who presented with a mass in the left chest that was suspected initially to be a tumor. This was later confirmed to be tuberculous in nature, with dissemination to the liver. A large granuloma eventually replaced the left lung, leaving her with "tuberculous destroyed lung" (TDL), an extremely rare, life-threatening sequela of the disease. We review the pathophysiology, radiologic findings, and management options, which includes pneumonectomy, for this seldom seen but preventable condition.

Topics: Antitubercular Agents; Child; Drug Therapy, Combination; Ethambutol; Female; Granuloma; Humans; Isoniazid; Lung; Lung Neoplasms; Mycobacterium tuberculosis; Pyrazinamide; Radiography; Rifampin; Treatment Outcome; Tuberculosis, Hepatic; Tuberculosis, Pulmonary

Though pulmonary tuberculosis (TBC) remains the commonest clinical presentation, extrapulmonary TBC is an increasingly important clinical problem. Among the extrapulmonary sites, primary liver tuberculosis seems to be an extremely rare location. Fewer than 100 cases of TBC hepatic abscesses have been reported whereas most of them have been originated from other sites, usually the lung and the gastrointestinal track. Therefore, in the absence of any particular symptom this infrequent location may lead to a delayed or missing diagnosis. The present study reports the difficulties in early diagnosis of an extrapulmonary TBC case, as it happened to a 53-year-old man with diabetic nephropathy who started on regular hemodialysis for 5 months. In such "atypical presentations" the clinicians should bear in their mind the possibility of the TBC occurrence, which usually responds well to the conventional antituberculous therapy.

Topics: Diabetic Nephropathies; Diagnosis, Differential; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Mycobacterium tuberculosis; Pyrazinamide; Renal Dialysis; Rifampin; Tomography, X-Ray Computed; Tuberculosis, Hepatic

Topics: Antibiotics, Antitubercular; Antitubercular Agents; Ethambutol; Humans; Isoniazid; Liver Abscess; Male; Middle Aged; Pyrazinamide; Rifampin; Tuberculosis, Hepatic

A 79-year-old woman was admitted to our hospital because of general fatigue. Chest radiograph and computed tomograph showed bronchiectasis and centrilobular nodules in the right middle lobe and lingula, which had not changed from previous examination. Intrahepatic nodular lesions and swelling of the left cervical lymph nodes, supraclavicular lymph node, abdominal paraaortic lymph nodes and inguinal lymph nodes was observed. Biopsy specimen of the liver lesion demonstrated epithelioid cell granulomas. Biopsy of the right inguinal lymph node demonstrated epithelioid cell granulomas with caseous necrosis and culture of the specimen showed Mycobacterium tuberculosis. The patient was diagnosed as having liver tuberculosis and multiple tuberculous lymphadenitis. Antituberculous treatment with isoniazid, rifampicin, ethambutol and pyrazinamide were started and continued for 6 months. All lesions improved after treatment. This was a rare case of liver tuberculosis that was difficult to distinguish from liver metastasis of cancer.

Topics: Aged; Antitubercular Agents; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Liver Neoplasms; Lymphatic Metastasis; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis, Hepatic; Tuberculosis, Lymph Node

Acquired ichthyosis is an uncommon disease usually associated with different systemic diseases. Its characteristic clinical sign is symmetrical scaling of the skin. We report a case of acquired ichthyosis revealing hepatic and lymph node tuberculosis.. A 41-year-old man was admitted to our hospital with weight loss and generalized acquired ichthyosis. Ultrasonography and computer tomography showed enlargement of abdominal lymph nodes. Lymph node and liver biopsy samples were taken during exploratory laparotomy and revealed multiple lymphoepitheliomas with Langhans-type giant cells and central caseous necrosis. The skin lesions resolved progressively after 5 months of antituberculous therapy.. Ichthyosis occurring in adulthood is often a sign of internal disease, especially malignant conditions. It has also been associated with autoimmune and infectious diseases, sarcoidosis and drugs. It is only rarely reported among patients with tuberculosis but it is possible that the ichthyosis in this case was due to weight loss and deterioration of the patient's general condition.

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Biopsy; Drug Therapy, Combination; Follow-Up Studies; Hepatitis C, Chronic; Humans; Ichthyosis; Isoniazid; Laparotomy; Liver; Lymph Nodes; Male; Pyrazinamide; Rifampin; Time Factors; Treatment Outcome; Tuberculosis, Hepatic; Tuberculosis, Lymph Node

Topics: Adult; Antibiotics, Antitubercular; Antitubercular Agents; Drug Therapy, Combination; Ethambutol; Female; Follow-Up Studies; Humans; Isoniazid; Pyrazinamide; Rifampin; Time Factors; Tomography, X-Ray Computed; Tuberculosis, Hepatic

The authors report two cases of tuberculous liver abscess. They stress the rarity of this site, and differential diagnostic difficulties with other types of infection and liver tumors, notably amebiasis, hydatid cyst and carcinoma. Echo- or Scan-guided needle biopsy is useful for diagnosis and, in some cases, treatment by drainage of the purulent cavity.

Topics: Adult; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Isoniazid; Liver Abscess; Pyrazinamide; Rifampin; Tuberculosis, Hepatic

Topics: Animals; Drug Resistance, Microbial; Guinea Pigs; In Vitro Techniques; Mycobacterium tuberculosis; Rabbits; Rifampin; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Lymph Node; Tuberculosis, Ocular; Tuberculosis, Splenic

Topics: Adolescent; Child, Preschool; Drug Tolerance; Ethambutol; Female; Humans; Isoniazid; Male; Prognosis; Rifampin; Time Factors; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Lymph Node; Tuberculosis, Pulmonary; Tuberculosis, Splenic

Topics: Bone Marrow; Bone Marrow Examination; Cholestasis; Erythema; Ethambutol; Humans; Isoniazid; Leukopenia; Male; Middle Aged; Neutropenia; Peritonitis, Tuberculous; Rifampin; Streptomycin; Thrombocytopenia; Tuberculosis; Tuberculosis, Hepatic; Tuberculosis, Osteoarticular; Tuberculosis, Splenic; Vitamin B Complex

Topics: Adult; Arthritis, Rheumatoid; Diagnosis, Differential; Female; Humans; Isoniazid; Male; Rifampin; Streptomycin; Tuberculosis, Hepatic; Tuberculosis, Ocular; Tuberculosis, Osteoarticular

Topics: Biopsy; Drug Tolerance; Ethionamide; Humans; Jaundice; Liver; Male; Middle Aged; Rifampin; Tuberculosis, Hepatic

Topics: Analysis of Variance; Animals; Drug Resistance, Microbial; Guinea Pigs; Isoniazid; Mycobacterium tuberculosis; Rifampin; Spleen; Streptomycin; Tuberculosis; Tuberculosis, Hepatic

Topics: Drug Synergism; Humans; Isoniazid; Jaundice; Rifampin; Tuberculosis; Tuberculosis, Hepatic