Pancreatic tuberculosis: A systematic review of symptoms, diagnosis and treatment.

INTRODUCTION: Although pancreatic tuberculosis (TB) is traditionally considered to be a rare clinical entity, in recent times, an increase in the number of reports of pancreatic TB has been noted. We conducted a systematic review in order to summarise currently available data on pancreatic TB. METHODS: A comprehensive literature search of Medline, Scopus and ISI Web of Science databases was conducted in order to identify papers reporting cases of pancreatic TB. The eligibility criteria for inclusion in the review required that the studies reported patient(s) affected by pancreatic TB and that individual data on age, sex, clinical presentation and outcome were available. RESULTS: In total, 116 studies reporting data on 166 patients were included in the analysis. The majority of patients were males (62.1%) diagnosed at a mean age of 41.61 ± 13.95 years. Most cases were diagnosed in Asia (50.0%), followed by North America (22.9%), Europe (20.5%), Africa (4.2%) and South America (2.4%). Human immunodeficiency virus (HIV) infection was diagnosed in 25.3% of those affected. Pancreatic TB most frequently presented itself in the form of a pancreatic mass (79.5%) localised mainly in the head (59.0%) and less frequently in the body (18.2%) and tail (13.4%). Extrapancreatic TB involvement most frequently affected the peripancreatic lymph nodes (47.3%). More than half of patients (55.2%) were subjected to laparotomy, while 21.08% underwent endoscopic ultrasound fine-needle aspiration biopsy. The presence of TB was identified most frequently through histological analysis (59.6%), followed by culture (28.9%), staining (27.7%) and, in a smaller number, by polymerase chain reaction (9.6%) and cytology (6.6%). Almost all patients received anti-tubercular pharmacological therapy (98.2%), while 24.1% underwent surgery. Despite treatment, 8.7% of patients died. CONCLUSION: Increased awareness of pancreatic TB is needed, not only in endemic areas but especially in relation to HIV infection and other clinical conditions associated with immunoincompetence.

Tuberculosis of the Breast in Togo: A Series of 28 Presumed Cases.

Our study aimed to describe the epidemiological, clinical and histological aspects of mammary tuberculosis in Togo. This is a descriptive cross-sectional study of breast tuberculosis for which the diagnosis was presumed on histological grounds in the pathology department (LAP) of the Lomé Tokoin university hospital from January 1995 to December 2016 (20 years). A total of 28 presumed cases of mammary tuberculosis were identified. There were 26 women and 2 men, with an average age of 34.2 ± 0.3 years. The clinical signs were nodule (84.1%), tumefaction (75%), abscess (63.6%) and tumefaction with cutaneous fistulization (59.1%). Breast involvement was isolated in 31.8% of cases and associated with pleuropulmonary tuberculosis in 54.5% of cases. Co-infection with HIV was found in 63.9 % of cases. Histology showed inflammatory granulomas made of Langhans giant cells, epithelioid cells and lymphocytes around the foci of caseous necrosis. Thoracic radiography was abnormal in 16 patients (57.1%).Mammary tuberculosis is not rare in our country. Clinical presentation is often misleading and is a diagnostic challenge, more particularly with breast abscess or cancer.

[Proportion and site distribution of extrarespiratory tuberculosis in 2007-2010 in Romania]. / Ponderea si structura pe localizari a tuberculozei extrarespiratorii in perioada 2007-2010 în România.

In the actual context of an increased TB endemia (notification rate of 90.5 per thousand, meaning 21457 cases in 2010, but with a constant decreasing trend in the last 8 years), we wanted to see what is the share and structure of extra-respiratory tuberculosis in the period 2007-2010. In the interval 2007-2010 have been registered annually between 1252-1267 extra-respiratory TB cases. Extra-respiratory TB have been between 30% and 42,1% from all TB cases registered annually with the extra-pulmonary TB. In the descending order of cases recorded with TB extra respiratory in 2010, the first was extra-thoracic ganglionary TB (244 cases), followed by osteo-articulary (233) and those of meningo-encephalitis and CNS TB (133). Location of TB on the spine remains the most common form of skeletal TB, representing 62.2% (145 cases) of all osteo-articulary locations. The number of registered cases of pericardial effusions TB annually remains steady at 40-50 cases. The number still high of meningo encephalitis TB (severe prognosis, epidemiological severity) involves enhanced accountability measures in TB control of the territory. The collaboration between the pulmonologist and the body specialist constitutes compulsory condition of quality assistance in case of TB extra respiratory sites.

Tuberculosis of the thyroid gland. A case report.

Tuberculosis of the thyroid gland is a very rare condition. A case of a 47-year-old female with a history of a euthyroid multi-nodular goitre is presented. The patient developed hoarseness due to right recurrent laryngeal nerve paralysis, confirmed with indirect laryngoscopy. On repeated ultrasound, volumetric progression of a dominant nodule in the inferior part of the right thyroid lobe was noticed. Fine needle aspiration was inconclusive. Diagnosis was ultimately based on histopathology of the surgical resection specimen.

Tuberculosis of the thyroid gland: review of the literature.

OBJECTIVE: Thyroid tuberculosis (TTB) is a very rare condition, even in countries with a high prevalence of tuberculosis. The aim of this article is to review and retrieve data about thyroid tuberculosis from the English-language literature in order to gain a better understanding of the clinical characteristics of TTB. STUDY DESIGN: We performed Medline, PubMed, and library searches using the key words "thyroid tuberculosis," "throid disease," "tuberculosis and thyroid." Reference lists of the articles obtained and previous reviews were also examined. RESULTS: We retrieved 76 cases matching our selection criteria from the search. Review of the cases with TTB revealed a slight female preponderance. The patients reported in the literature ranged in age from 9 to 83 years, with a median age of 40+/-16 years for men and 44+/-17 years for women. In the articles surveyed, TTB presented with a broad spectrum of manifestations, ranging from an isolated nodule to thyrotoxicosis. It seems that diagnosis of thyroid tuberculosis has recently been increasing, perhaps because of the growing incidence of tuberculosis and the diagnostic use of fine-needle aspiration cytology in the diagnosis. Although, in the past, the diagnosis was generally made by the examination of the specimens, at present, fine-needle aspiration cytology seems to be a useful method in diagnosis tuberculous thyroiditis. The role of surgery is limited after the diagnosis. The choice of treatment should be medical antituberculous therapy. CONCLUSIONS: Preoperative diagnosis of thyroid tuberculosis is important because of the availability of medical treatment and the limited role of surgery. This condition should be kept in mind in evaluating patients with a thyroid nodule, in communities where the prevalence of tuberculosis is high.

Extrapulmonary tuberculosis in Oklahoma, 1965 to 1973.

Three hundred seventy cases of extrapulmonary tuberculosis were reported to the Oklahoma State Department of Health between January 1, 1965 and December 31, 1973. The annual number of cases reported showed no tendency to decrease with time. A greater proportion of cases reported in recent years had bacteriologic confirmation. When compared to the distribution of all newly diagnosed cases of tuberculosis in the population, a greater proportion of newly diagnosed cases of extrapulmonary tuberculosis occurred in nonwhites. This was especially true to tuberculous meningitis, tuberculous lymphadenitis, and miliary tuberculosis. Possible reasons for the failure of the number of newly reported cases of extrapulmonary tuberculosis to decrease in recent years are presented.