DISSEMINATED TUBERCULOSIS PRESENTING AS AN ACUTE ABDOMEN

Akash Pawar, Vaibhav Yadav, Rahul Dubepuria, MD Yunus, Amit Priyadarshi
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Abstract

Mycobacterium tuberculosis is a widespread infection in developing countries like India. Tuberculosis is primarily a chronic condition but can present with acute and unusual manifestations. Disseminated tuberculosis is defined as having two or more non-contiguous sites resulting from lymphohematogenous dissemination of mycobacterium tuberculosis ex.: Miliary TB. Before COVID-19, tuberculosis was the worlds leading cause of death due to a single infectious agent. Especially in India because India accounts for one-quarter of the global burden and prevalence, the incidence rate of Latent TB Infection (LTBI) and active tuberculosis is 33% & 36% respectively in India which is quite high, therefore it is important to consider tuberculosis as an etiological agent if symptom indicates and subsequent work up consideration. Here we are reporting a rare presentation of disseminated tuberculosis in an emergency department at a tertiary care center with sub-acute intestinal obstruction to emphasize the importance of clinical examination and history to evaluate for the cause, for the management of patients even in acute settings like emergency.
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以急腹症为表现的播散性结核病
结核分枝杆菌是印度等发展中国家普遍存在的一种传染病。结核病主要是一种慢性病,但也可能出现急性和异常表现。播散性结核病的定义是结核分枝杆菌淋巴血行播散引起的两个或两个以上非毗连部位的结核病,例如:纤溶性结核病。在 COVID-19 之前,结核病是世界上单一传染源导致死亡的主要原因。尤其是在印度,因为印度的结核病负担和发病率占全球的四分之一,印度的潜伏肺结核感染(LTBI)和活动性肺结核发病率分别为 33% 和 36%,相当高,因此,如果有症状提示,必须将结核病视为病原体,并考虑后续治疗。在此,我们报告了在一家三级医疗中心急诊科出现的罕见的播散性肺结核,并伴有亚急性肠梗阻,以强调临床检查和病史对病因评估的重要性,即使在急诊等急性环境下也要对患者进行管理。
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