Tuberculosis with pulmonary and peritoneal involement

Case contributed by Dr Andrew Dixon

Presentation

HIV on ART for 1 month. Cough and abdominal discomfort.

Patient Data

Age: 35 years
Gender: Female

Regions of bilateral upper lobe (and small area within right lower lobe) tree in bud nodularity most consistent with active small airways infection. No cavitating lesion. No pleural effusion. There is no hilar lymphadenopathy. Left axillary and upper left paratracheal lymphadenopathy. Bilateral epicardial lymphadenopathy. There are ill-defined soft-tissue density deposits within the omentum and mesentery with a small volume ascites. Normal appearance of the liver. Spleen is mildly enlarged. Both ovaries contain multiple follicles. Para-aortic lymphadenopathy and mesenteric lymphadenopathy. Mildly prominent inguinal lymph nodes. 

Case Discussion

Clinical history and imaging appearances in keeping with tuberculosis, with active small airways infection predominantly in the upper lobes, lymphadenopathy within the chest and abdomen, and peritoneal disease (TB peritonitis). Diagnosis of TB was subsequently confirmed. 

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Case Information

rID: 49768
Case created: 3rd Dec 2016
Last edited: 13th Mar 2017
System: Chest
Inclusion in quiz mode: Included

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