[Hepatic tuberculosis presenting as prolonged fever]. / Tuberculoza hepatica manifestare a sindromului febril prelungit.

In our country prolonged fever is frequently caused by tuberculosis infection, that is recrudescent. Localized hepatic tuberculosis is a rare clinical form of this specific infection. The authors present the case of a 26 year old man who developed prolonged fever, highly elevated liver enzymes and meningitis syndrome and was admitted to Clinical Hospital of Infectious Diseases and Pneumophtisiology Dr. V. Babes Timisoara during 24.03 - 16.05.2008. Diagnosis of hepatobiliary tuberculosis, acute bacillary meningitis and miliary tuberculosis were established by clinical, laboratory criteria and sustained by imaging techniques. Dynamics of biological features, diagnostic pitfalls, differential diagnosis difficulties, therapeutic schedules and peculiar aspects of evolution are presented. Liver involvement can be the only manifest form of miliary tuberculosis and when it is associated with prolonged fever obligates to begin quadruple specific therapy, especially in communities where tuberculosis is prevalent. Bacteriological findings are belated and antituberculous therapy can not be started early. Quadruple association of antituberculous drugs with corticotherapy and liver protective medication showed utility in favorable resolving of this case.