Clinical and ultrasonographic features of abdominal tuberculosis in HIV positive adults in Zambia

  • Sinkala E
  • Gray S
  • Zulu I
 et al. 
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Abstract

BACKGROUND: The diagnosis of abdominal tuberculosis (TB) is difficult, especially so in health care facilities in developing countries where laparoscopy and colonoscopy are rarely available. There is little information on abdominal TB in HIV infection. We estimated the prevalence and clinical features of abdominal (excluding genitourinary) TB in HIV infected adults attending the University Teaching Hospital, Zambia. METHODS: We screened 5,609 medical inpatients, and those with fever, weight loss, and clinical features suggestive of abdominal pathology were evaluated further. A clinical algorithm was used to specify definitive investigations including laparoscopy or colonoscopy, with culture of biopsies and other samples. RESULTS: Of 140 HIV seropositive patients with these features, 31 patients underwent full evaluation and 22 (71%) had definite or probable abdominal TB. The commonest presenting abdominal features were ascites and persistent tenderness. The commonest ultrasound findings were ascites, para-aortic lymphadenopathy (over 1 cm in size), and hepatomegaly. Abdominal TB was associated with CD4 cell counts over a wide range though 76% had CD4 counts

Author-supplied keywords

  • AIDS-Related Opportunistic
  • Abdomen/*ultrasonography
  • Adolescent
  • Adult
  • CD4 Lymphocyte Count
  • Colonoscopy
  • Female
  • Gastrointestinal/complications/diagnosis/epidemiol
  • HIV Seropositivity/*complications
  • Hospitals, University
  • Humans
  • Infections/complications/diagnosis/epidemiology/*u
  • Laparoscopy
  • Male
  • Middle Aged
  • Prevalence
  • Tuberculosis,
  • Young Adult
  • Zambia/epidemiology

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Authors

  • E Sinkala

  • S Gray

  • I Zulu

  • V Mudenda

  • L Zimba

  • S H Vermund

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