Tuberculous appendicitis: A review of reported cases over the past 10 years
Title
Tuberculous appendicitis: A review of reported cases over the past 10 years
Creator
Hubbard G; Chlysta W
Publisher
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
Date
2021
Description
Background: Tuberculous appendicitis is a rare extrapulmonary manifestation of tuberculosis without clear summarization or consensus on its management.
Data sources: Case reports were gathered from several online literature databases by searching terms "tuberculosis", "tuberculous", and "appendicitis".Report eligibility criteria: Cases of appendicitis due to M. tuberculosis identified on operative histology. Exclusion criteria: appendicitis caused by a mycobacterium other than M. tuberculosis, and appendiceal tuberculosis identified incidentally during procedures for other reasons.
Results: Thirty four patients were identified. Twenty five patients presented with acute right lower quadrant abdominal pain. Eleven patients described chronic symptoms of tuberculosis (cough, night sweats, or weakness/fatigue). Four patients had a known diagnosis of TB. Seven of 24 cases reported peri-operative chest imaging which demonstrated pulmonary lesions. AFB were present in tissue or fluid samples of 6 patients, and negative in 15 patients. All patients underwent pharmacotherapy on a WHO-recommended anti-tuberculous treatment (ATT) with RIPE or an alternative. The average duration of treatment was 7.2 ± 1.7 months.
Limitations: Data was gathered from case reports without complete uniformity in diagnostic work-up. The potential for larger scale study is limited due to disease rarity.
Conclusions: Tuberculous appendicitis cannot be diagnosed prior to histologic evaluation. Several data points may suggest the disease on a clinician's differential diagnosis if they present with a combination of the following: born in a country with endemic tuberculosis; chronic cough, weakness/fatigue, or nausea prior to onset of abdominal pain; pulmonary lesions on chest X-ray; white studding of the mesentery or peritoneum in a young patient; positive AFB stain of abdominal fluid or peritoneal tissue.
Data sources: Case reports were gathered from several online literature databases by searching terms "tuberculosis", "tuberculous", and "appendicitis".Report eligibility criteria: Cases of appendicitis due to M. tuberculosis identified on operative histology. Exclusion criteria: appendicitis caused by a mycobacterium other than M. tuberculosis, and appendiceal tuberculosis identified incidentally during procedures for other reasons.
Results: Thirty four patients were identified. Twenty five patients presented with acute right lower quadrant abdominal pain. Eleven patients described chronic symptoms of tuberculosis (cough, night sweats, or weakness/fatigue). Four patients had a known diagnosis of TB. Seven of 24 cases reported peri-operative chest imaging which demonstrated pulmonary lesions. AFB were present in tissue or fluid samples of 6 patients, and negative in 15 patients. All patients underwent pharmacotherapy on a WHO-recommended anti-tuberculous treatment (ATT) with RIPE or an alternative. The average duration of treatment was 7.2 ± 1.7 months.
Limitations: Data was gathered from case reports without complete uniformity in diagnostic work-up. The potential for larger scale study is limited due to disease rarity.
Conclusions: Tuberculous appendicitis cannot be diagnosed prior to histologic evaluation. Several data points may suggest the disease on a clinician's differential diagnosis if they present with a combination of the following: born in a country with endemic tuberculosis; chronic cough, weakness/fatigue, or nausea prior to onset of abdominal pain; pulmonary lesions on chest X-ray; white studding of the mesentery or peritoneum in a young patient; positive AFB stain of abdominal fluid or peritoneal tissue.
Subject
Appendix; Extrapulmonary tuberculosis; Gastrointestinal tuberculosis; Public health; Surgery; Tuberculous appendicitis
Identifier
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Format
journalArticle
URL Address
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NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of General Surgery
Citation
Hubbard G; Chlysta W, “Tuberculous appendicitis: A review of reported cases over the past 10 years,” NEOMED Bibliography Database, accessed April 23, 2024, https://neomed.omeka.net/items/show/11754.