Abstract:
This editorial article takes an opportunity to apprehend the diagnostic challenges of primary gastrointestinal tuberculosis (an uncommon extrapulmonary tuberculosis condition) utilizing the recently published case report of a young male with prolonged gastrointestinal symptoms and weight loss who received intermittent anti-tubercular treatment and underwent operative interventions to relieve gastric outlet obstruction. The diagnosis chiefly relied on high-end examinations, like computed tomography scans and histopathological evaluation of post-operatively resected bowel tissue, which wasn\'t preceded by an all-inclusive stepwise primary pulmonary tuberculosis exclusion approach that usually begins with a detailed tuberculosis-pertinent history acquisition. Given the geographic locations where the patient had been (and/or treated), pivotal consideration of tuberculosis-associated endemicities in those regions, like human immunodeficiency virus (HIV) infection, might have improved the case description. The obtainment of HIV-relevant histories, like intravenous drug use and sexual practice, are good places to start. The sputum bacteriology also seems imperative to rule out atypical Mycobacterium species infection because of its clinico-radio-histopathological resemblance with pulmonary Mycobacterium tuberculosis. Altogether, this editorial aims to underscore that primary extrapulmonary tuberculosis diagnosis should comprise an elaborative, comprehensive, systematic, and stepwise primary pulmonary Mycobacterium tuberculosis exclusion workup.
摘要:
这篇社论文章利用最近发表的病例报告,了解原发性胃肠道结核(一种罕见的肺外结核疾病)的诊断挑战,该病例报告涉及一名患有胃肠道症状延长和体重减轻的年轻男性,他接受了间歇性抗结核治疗并接受了手术干预以缓解胃出口梗阻。诊断主要依靠高端检查,如计算机断层扫描扫描和手术后切除的肠组织的组织病理学评估,之前没有全包式逐步原发性肺结核排除方法,通常从详细的结核病相关病史获取开始。鉴于患者曾经(和/或治疗)的地理位置,对这些地区结核病相关流行病的关键考虑,比如人类免疫缺陷病毒(HIV)感染,可能改进了案例描述。获得与艾滋病毒相关的历史,比如静脉注射毒品和性行为,是好的开始。痰细菌学似乎也必须排除非典型分枝杆菌感染,因为其临床放射组织病理学与肺结核分枝杆菌相似。总之,这篇社论旨在强调原发性肺外结核病的诊断应该包括一个详细的,全面,系统,和逐步的原发性肺结核分枝杆菌排除检查。