Tuberculosis in the belly: a review of forty-six cases involving the gastrointestinal tract and peritoneum.

BACKGROUND: Abdominal tuberculosis has varied presentation and can be confused with other conditions. METHODS: We report our experience with 46 patients. Charts of patients managed during 1984-97 were reviewed. RESULTS: Fifty-two percent were women and mean age was 46 years. Presenting symptoms were as follows: fever 70%; abdominal pain 70%; weight loss 68%; abdominal swelling 67%; change in bowel habit 39%; anorexia 30%; and sweating 30%. Common physical signs were as follows: fever 73%; ascites 61%; abdominal mass 13%; and doughy abdomen 9%. Thirty percent of patients either gave past history of TB or presented with active TB of other sites. TB skin test was positive in only 27% of patients. CT scans of abdomen were abnormal in 80%, showing ascites, peritoneal lesions or enlarged nodes. Ascitic fluid was diagnostic for TB on smear/culture in 33%. Peritoneal biopsy was performed by laparoscopy or laparotomy in 61%. It was positive for ganulomas in 97% and for smear/culture in 68%. Forty-two patients recovered after receiving anti-TB therapy for 9-12 months. Four patients died. One died within 1 month of initiation of therapy due to extensive TB, and death in the other 3 was due to unrelated causes. CONCLUSION: Abdominal TB should be suspected in patients with fever, abdominal pain and ascites. This condition carries good prognosis if promptly diagnosed and treated.

Cross-protection studies with vaccine strain H-120 of infectious bronchitis virus using ciliary activity.

Forty 3-day-old chickens were immunized intratracheally and another 40 intranasally-intraocularly with vaccine strain H-120 of infectious bronchitis virus (IBV). The chickens were divided into groups of five and each group was challenged intratracheally or intranasally-intraocularly with one of 8 different heterologous strains of IBV 4 weeks after vaccination. The vaccinated chickens were protected against challenge with three heterologous strains (Massachusetts M41, B and AEG), showing 89, 86 and 89% ciliary activity, respectively, but were not protected against challenge with strains D-3896 and D-3128. Clinical signs and/or a reduction in ciliary activity was observed neither for the vaccinated nor for the unvaccinated groups challenged with strains Sz, D-207 and D-212. This suggests that these isolates have no primary pathogenic role in broiler flocks. The remaining 5 strains (M41, B, AEG, D-3896 and D-3128) caused mild respiratory signs and ciliostasis in birds of the unvaccinated groups.