ABSTRACT
Objective To understand the clinical features of splenic tuberculosis. Methods The clinical manifestations, laboratory tests, treatment outcomes of a case of splenic tuberculosis caused by hematogenous pulmonary tuberculosis were analyzed. Related literatures about splenic tuberculosis were also reviewed. Results The patient was a 19-year-old male. Cough, fever, night sweats, and weight loss were the main manifestations. Thoracoscopy revealed tuberculosis and imaging suggested splenic tuberculosis and tuberculosis in multiple body sites. Anti-tuberculosis treatment was effective in improving patient conditions. According to literature review, there are two types of splenic tuberculosis: primary splenic tuberculosis or as part of hematogenous pulmonary tuberculosis.The clinical manifestations of primary splenic tuberculosis are usually atypical. Immune deficiency is a significant risk factor of splenic tuberculosis. The main clinical manifestations of splenic tuberculosis are splenomegaly, fever, digestive system symptoms, and occasionally spontaneous splenic rupture (3/32). Most of the patients with splenic tuberculosis (28/32) were cured or improved by anti-tuberculosis treatment and/or splenectomy. Conclusions The onset of splenic tuberculosis is mostly insidious and clinical symptoms usually atypical. The diagnosis relies on radiographic findings, biopsy and pathological examination. Anti-tuberculosis and selective splenectomy are the effective treatment. The outcome of splenic tuberculosis is good in most patients.
ABSTRACT
Tuberculosis infection of skeletal muscle is rare even in countries in which tuberculosis is a relatively common disease. Because tuberculosis of muscle is almost always secondary to underlying tuberculosis of the bone or adjacent joint, hematogenous tuberculosis of skeletal muscle is extremely rare. Therefore, We report a case of hematogenous tuberculosis of skeletal muscle with the review of literatures. A 79-year-old man presented with a history of left shoulder pain, edema, fever and chill. MRI showed inflammatory changes of infraspinatus and deltoid muscle. The histopathology of skeletal muscle showed granulomas surrounded by epithelioid cells and Langhans' giant cells. Mycobacterium tuberculosis was grown from the specimens of sputum, pleural fluid and muscle tissue. The patient improved on anti-tuberculosis treatment.