Intra‐abdominal and gastrointestinal tuberculosis

Rasheed, Shahnawaz; Zinicola, R.; Watson, Dave; Bajwa, Abubakr; McDonald, Peter J.

doi:10.1111/j.1463-1318.2007.01337.x

Cited by 137 publications

(143 citation statements)

References 129 publications

(211 reference statements)

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“…Tuberculosis involvement of the gut can involve the ileocecal area with abscesses presenting as abdominal pain, gastrointestinal tract bleeding, bowel perforation (similar to Crohn's disease). 35 Among liver transplant recipients with tuberculosis, hepatic inflammation is common and other sites can be involved: muscle, joints, skin, and central nervous system, and lymph nodes. 36,37 Fever, night sweats, and weight loss are frequent constitutional symptoms.…”

Section: Tuberculosismentioning

confidence: 99%

Infections After Orthotopic Liver Transplantation

Pedersen

Seetharam

2014

Journal of Clinical and Experimental Hepatology

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Opportunistic infections are a leading cause of morbidity and mortality after orthotopic liver transplantation. Systemic immunosuppression renders the liver recipient susceptible to de novo infection with bacteria, viruses and fungi post-transplantation as well to reactivation of pre-existing, latent disease. Pathogens are also transmissible via the donor organ. The time from transplantation and degree of immunosuppression may guide the differential diagnosis of potential infectious agents. However, typical systemic signs and symptoms of infection are often absent or blunted after transplant and a high index of suspicion is needed. Invasive procedures are often required to procure tissue for culture and guide antimicrobial therapy. Antimicrobial prophylaxis reduces the incidence of opportunistic infections and is routinely employed in the care of patients after liver transplant. In this review, we survey common bacterial, fungal, and viral infections after orthotopic liver transplantation and highlight recent developments in their diagnosis and management. ( J CLIN EXP HEPATOL 2014;4:347-360) I nfection after orthotopic liver transplantation (OLT) is a major cause of morbidity and mortality. Infection is estimated to occur in upto 80% of organ recipients. Bacterial infections are most frequent (70%), followed by viral (20%) and fungal infections (8%). 1,2,3 In addition to direct effects of infection and end-organ inflammation, pathogens may have a number of indirect effects that result in allograft injury, rejection and opportunistic superinfection.The risk of infection in liver transplant recipients is determined by the intensity of exposure to infectious agents and the overall level of immunosuppression. 4 In addition, conditions attendant to end-stage liver disease in the immediate perioperative period may render a recipient vulnerable to infection and include: neutropenia, deficits in mucocutaneous barrier integrity, presence of necrotic tissue, ischemia, diabetes mellitus, immunomodulating viruses, uremia, and protein-calorie malnutrition. 5 Infectious exposures come from many sources post liver transplant including: de novo (acquired acute) in the recipient, reactivation in the recipient, the donor organ, and nosocomial and time from transplant may provide clues to etiology (Figure 1). The overall level of immunosuppression is dependent upon the dose, duration, and choice of immunosuppression as well as underlying immune deficiencies. 6 Inflammatory responses to invading pathogens are often blunted by immunosuppressive therapy, and as a result, the classic signs or symptoms of infection may be absent. A high index of suspicion is need in the liver recipient, and a low threshold to perform invasive diagnostic procedures is often required. It is critical to identify clinical factors that predispose recipients to infection and much interest centers on identifying risk factors for infection after liver transplant. GENETIC POLYMORPHISMS IN THE INNATE IMMUNE SYSTEMIn addition to clinical factors that promote ...

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Section: Tuberculosismentioning

confidence: 99%

Infections After Orthotopic Liver Transplantation

Pedersen

Seetharam

2014

Journal of Clinical and Experimental Hepatology

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“…La TB gastrointestinal representa el 3-5% de todos los casos de TB extrapulmonar, reportándose que hasta el 20% de los sujetos con TB pulmonar presentan manifestaciones extra-pulmonares que incluyen enfermedades intraabdominales, sin embargo, se desconoce su real incidencia (Hamer & Gorbach, 1998;Marshall, 1993;Rasheed et al, 2007).…”

Section: Introductionunclassified

Tuberculosis Intestinal Secundaria: Hallazgos Morfológicos en un Caso con Desenlace Fatal

2012

Int. J. Morphol.

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. Tuberculosis intestinal secundaria: hallazgos morfológicos en un caso con desenlace fatal. Int. J. Morphol., 30(1):347-353, 2012. RESUMEN:La tuberculosis gastrointestinal (TB GI) representa el 3-5% de todos los casos de TB extrapulmonar, reportándose que hasta el 20% de los sujetos con TB pulmonar presentan manifestaciones extra-pulmonares que incluyen enfermedades intra-abdominales, sin embargo, se desconoce la real incidencia del compromiso intestinal. La región ileocecal representa el sitio anatómico más frecuentemente afectado (85-90%), siendo actualmente la colonoscopía la herramienta diagnóstica de mayor utilidad. Se presentan los hallazgos morfológicos del examen post-mortem de una paciente en estudio por baja de peso y masa en región cecal. La necropsia realizada en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco concluyó una TB pulmonar bilateral con compromiso secundario intestinal y linfonodal.

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“…Although laparoscopy-guided peritoneal biopsy was accepted as the most sensitive and specific diagnostic tool for early identification of TBP, the invasiveness and potential complications of this test, as well as, the scarcity of gastroenterologists with experience in this procedure have prevented this tool from being widely adopted (6).…”

Section: Introductionmentioning

confidence: 99%