The Clinical Feature Analysis Of Six Cases Of Hepatic Tuberculosis

ObjectiveBy discussing the experience of diagnosis and treatment of hepatic tuberculosis, so as to reduce the clinical misdiagnosis and missed diagnosis.MethodsClinical manifestations and treatment situation of6cases of patients with hepatic tuberculosis admitted in our hospital between May2009and February2015were analyzed retrospectively.ResultsSix cases of liver TB were diagnosed by clinical or pathology. There are four cases of men and two cases of women. The ages vary from27to58years. Of the cases, two have a history of peritoneum tuberculosis infection. Common symptoms are fever, chills, night sweats, fatigue, weight loss and other systemic manifestations, anorexia, nausea, vomit and abdominal pain. Abnormal laboratory results contain anemia, elevated blood sedimentation, gamma glutamyl transpeptidase (GGT), C-reactive protein (CRP), alkaline phosphatase (ALP), ferritin and adenosine deaminase (ADA), decreased albumin, positive mycobacterium tuberculosis antibody and T-SPOT.TB. Its imaging examination varies from abscess to tumor-like masses. Pathological examination of liver showed granulomatous inflammation in four cases and acid fast bacilli in one case. The liver pus of acid-fast stain is positive in one case. The symptoms of all cases improved after the mainly anti-tuberculosis treatment. Among the cases, four got better in imaging and laboratory examination.ConclusionThe manifestation and examination of hepatic tuberculosis have no specificity. Identification of hepatic tuberculosis should be considered when meeting the case of unexplained fever, abdominal pain, emaciation, night sweats, anemia, high blood sedimentation, GGT and ALP, ADA, abnormal ultrasound and CT changes. The bacteriology and pathology examination of liver should be taken as soon as possible when doubted. The treatment of liver tuberculosis is still the quadruple anti-tuberculosis therapy as the main drug treatment. We must attach great importance to the diagnosis of hepatic tuberculosis to reduce the misdiagnosis and missed diagnosis, and improve the effect of treatment.