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ECR 2018 / C-2853
Tuberculosis where you least expect it – a review of extrapulmonary imaging manifestations
Congress: ECR 2018
Poster No.: C-2853
Type: Educational Exhibit
Keywords: Tropical diseases, Infection, Education and training, Imaging sequences, Education, Diagnostic procedure, MR, CT, Conventional radiography, CNS, Abdomen, Retroperitoneum
Authors: L. M. Zammit1, N. Bonanno2, A. Mizzi3; 1Paola/MT, 2Msida/MT, 3ATTARD/MT
DOI:10.1594/ecr2018/C-2853

Background

Our local incidence of Mycobacterium tuberculosis infection has been increasing paralleling what is happening in mainland Europe in view of immigartion of populations where Tuberculosis, (TB) is endemic.


Dissemination of TB occurs by haematological or local spread.


The patient tends to present with non- specific symptoms of:

  1. fever
  2. lethargy
  3. anorexia

In addition, patients present with complications from the affected site like:

  1. neck stiffness and vomiting in tubreculous meningitis;
  2. change in bowel habits in intestinal TB;
  3. haematuria in renal tuberculosis;
  4. bone pains with pathological fracture in skeletal infection.

 

Risk factors for Tuberculous infection include:

  1. Endemic places
  2. HIV/ AIDS
  3. Immunosuppression
  4. Intravenous drug use
  5. Alcoholism
  6. Diabetes mellitus

The diagnosis is  confirmed through a combination of microscopy, culture and molecular testing, as well as radiological findings.

 

Results may not perfectly tally to support the diagnosis, making TB a diagnostic challenge for the caring physician.

 

Treatment is multimodal and prolonged in view of organism resistance, often underlying immunosuppression, pharmacokinetics of therapies and in our experience, language and cultural barriers.

 

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