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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a homosexual patient with the acquired immune deficiency syndrome (AIDS) and histopathologic evidence for cytomegalovirus (CMV) appendicitis in a patient with no prior history of CMV infection. The patient presented with right lower quadrant pain and intermittent fevers. The diagnosis of appendicitis was difficult to make in this patient because of the presumptive diagnosis of tuberculosis ileitis and the frequent presentation of abdominal pain with fever in AIDS patients. Although CMV colitis is frequently seen in AIDS patients, the prevalence of CMV appendicitis is exceedingly rare. The problems related to making a diagnosis of CMV appendicitis and the therapeutic management of CMV infections are reviewed.
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PMID:Cytomegalovirus appendicitis in a patient with acquired immune deficiency syndrome. 164 60

Although conventional wisdom advises removal of the Tenckhoff catheter as part of the therapy for tuberculous peritonitis, there are a few recent reports of cases successfully treated while maintaining the patients on CAPD. We wish to report three cases treated without interrupting CAPD. In two of the patients, cultures were positive for Mycobacterium tuberculosis and in the third case, although the cultures were negative, the patient improved on anti-Tb medications. Smear for AFB was positive in one patient; and two had a positive PPD. All had predominance of lymphocytes and monocytes in effluent. The total WBC count was 160-300 and two patients had fever. All had abdominal pain. One patient was treated with INH and ethambutol; one with INH and rifampin and one (who was suspected of being HIV+) also received pyrazinamide (PZA) until culture was available. Cultures grew in 4-6 weeks. All were started on therapy prior to having the culture results, and all showed clinical improvement within two weeks. One patient had his catheter replaced two months later because of pseudomonas peritonitis, continued on CAPD for an additional five months, then changed to HD because of recurrent bacterial peritonitis. One patient died of complications of diabetic vascular disease three months later with no evidence of peritonitis. One patient has remained on anti-Tb treatment for seven months and is doing well on CAPD.
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PMID:Successful treatment of tuberculous peritonitis while maintaining patient on CAPD. 168 Apr 1

A 13-year-old girl presented with fever, night sweat, weight loss, abdominal pain, haematuria and hepatosplenomegaly. Urinalysis revealed many Schistosoma haematobium ova, but rectal snip examination was negative for schistosomal ova. X-ray and CT scan of the chest revealed enlargement of the anterior, superior, mediastinal and left suprahilar lymph node with an adjacent left pulmonary parenchymal opacity and small peripheral lesions on the right side. A bone marrow aspiration and biopsy was normal. The patient was treated with Praziquantel for her urinary schistosomiasis. Because of her clinical and radiological chest findings, the possibilities of lymphoma and tuberculosis were considered. Therefore, she underwent a thoracotomy and biopsy of her thoracic lesions. The histopathology revealed pulmonary granulomas surrounding schistosoma ova with reactive mediastinal lymph adenitis.
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PMID:Schistosomiasis associated with a mediastinal mass: case report and review of the literature. 170 47

Contrary to widespread belief, abdominal tuberculosis is not rare, nor is it confined to the poor or patients with active pulmonary tuberculosis. The disease must be considered in the differential diagnosis of abdominal pain.
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PMID:Tuberculous peritonitis: an overlooked diagnosis. 173 Jul 95

Tuberculosis of the spine or ribs is uncommon, occurring in less than 1% of patients with tuberculosis (TB). 2 women are presented who recently immigrated from Ethiopia and India, respectively. One, aged 55, presented with chest pain, fatigue and several masses under the skin of the scalp. Chest X-ray and CT scan suggested Pancoast tumor, and the lateral parts of the first 2 right ribs were absent. The origin of the patient, clinical findings and positive PPD suggested TB of the ribs and anti-TB therapy resulted in cure. The diagnosis was later confirmed by a positive culture. The other woman, aged 68, presented with fatigue, mild abdominal pain and axillary lymphadenopathy. The PPD was positive and X-ray showed widening of the mediastinum. A caseating granuloma with Langhans epithelioid cells was found in a lymph node. Flaccid paraparesis developed before therapy was started. CT scan showed a typical picture of TB affecting the T3-T6 vertebrae. Drainage of a cold abscess of the spine via the anterior approach was followed by anti-TB therapy. Culture of a biopsied lymph node and of pus obtained at operation confirmed the diagnosis of TB. The patient died 2 months later from gastrointestinal bleeding. Awareness of the unusual presentations of various forms of TB is mandatory in countries with immigration from countries in which TB is still common.
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PMID:[Tuberculosis of the spine and ribs]. 175 49

Gastrointestinal tuberculosis is a rare disease in industrial countries. The most frequent localisation is the ileocaecal region. We report about two cases of stenotic ileocaecal tuberculosis, treated by surgical resection. The main clinical symptoms are abdominal pain, weight loss and low-grade fever. Uncomplicated cases responses successfully to antituberculous drugs, just complications require surgery.
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PMID:[Ileocecal tuberculosis. A rare disease picture]. 177 38

From 1960 to 1989, a total of 121 patients with abdominal tuberculosis were treated at this hospital. Ages, at the time of diagnosis, ranged from 14 years to 81 years with a mean of 44 years. There were 86 males and 35 females. No clinical feature was diagnostic, but the leading presenting complaints were abdominal pain (79%) and fever (53%). Chest x-ray showed that 80 patients (69%) had coexisting evidence of pulmonary tuberculosis. Lesions were most commonly located at the ileocecal region (40%). The diagnosis was bacteriologically established in only 39 patients (32%). It was difficult to obtain the definitive diagnosis, most of our patients (91 cases) were diagnosed while undergoing laparotomy with tissue biopsy. Although the principal treatment of abdominal tuberculosis was chemotherapy and operation should be reserved until complications occurred, there were still 96 patients (79%) who underwent surgical procedures. The reasons of high operative rate were the difficulty of early diagnosis and the delay of proper treatment. The common complications of abdominal tuberculosis and the related managements were discussed and the findings in our cases which were helpful in diagnosing abdominal tuberculosis were also presented. Sixteen severely ill patients who died tended to be older, poor nutrition and associated with underlying medical diseases. Abdominal tuberculosis is still persistent in Taiwan, and it must be included in the differential diagnosis of obscure abdominal conditions to avoid diagnostic delay and unnecessary illness and death.
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PMID:Abdominal tuberculosis--a retrospective analysis of 121 cases. 184 59

We present a patient with acute and severe abdominal pain, fever and mild tenderness elicited on deep palpation in the right lower quadrant. X-ray films of the chest and abdomen were normal. The ultrasonographic study, barium enema examination and colonoscopic study avoided a diagnostic laparotomy. A purified protein skin test (PPD) and the cultures on Lowestein medium were negative. The final diagnosis was ulcero-hipertrophic tuberculosis of the ascending colon, and was confirmed by the finding of positive acid fast facilli and granulomas with Langerhans cells in the colonic biopsy material. The colonic lesions disapplared at the end of the antituberculous treatment.
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PMID:[Colonic tuberculosis. Endoscopic diagnosis]. 193 Dec 47

A study was conducted among women in Khayelitsha to determine the relationship between urbanisation, health status and use of health services; 722 households were visited, and 659 female respondents provided information on acute and chronic illness for the 3,229 individuals who were members of their households. In addition, they provided information concerning their reproductive health, AIDS awareness, knowledge of cervical smears and use and knowledge of health services. Acute illness was reported for 4.3% of the study population, the commonest complaints being diarrhoea, abdominal pain and upper respiratory infections; 4.4% reported chronic illness, the commonest complaints being hypertension and tuberculosis; 16.2% of women reported gynaecological illness; 86% had of heard of AIDS (although their knowledge of transmission and prevention was poor); and 45% had heard of cervical smears. Patterns of illness and knowledge and use of health services vary in the different areas of residence of Khayelitsha. This appears to be related to urbanisation, age, and environmental and socio-economic factors.
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PMID:Urbanisation and women's health in Khayelitsha. Part II. Health status and use of health services. 202 Aug 80

Seventeen patients with abdominal tuberculosis were recently treated at our institution. Two distinct patient populations were identified--immigrants and individuals infected with the human immunodeficiency virus. Abdominal pain, weight loss and fever were the most common complaints, with abdominal tenderness and pyrexia the most frequent physical findings. Only five of 17 patients had concomitant pulmonary tuberculosis. A typical computed tomographic scan was helpful in the diagnosis. Diagnosis was made at emergency (five patients) or elective (six patients) laparotomy, by endoscopic (two patients) or percutaneous (three patients) biopsy or on the basis of roentgenologic and clinical evidence (one patient). All responded to antituberculous chemotherapy. With the spread of acquired immunodeficiency syndrome (AIDS), tuberculosis has become increasingly frequent in urban areas and it must be suspected in all immigrants and patients with AIDS presenting with abdominal complaints.
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PMID:The reappearance of abdominal tuberculosis. 203 31


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