|LETTER TO EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 480
Isolated hepatic tuberculosis: A disease of multifaceted presentations
Department of Health Sciences, University “Magna Graecia,” Catanzaro, Italy
|Date of Submission||16-Oct-2021|
|Date of Acceptance||26-Oct-2021|
|Date of Web Publication||14-Dec-2021|
Department of Health Sciences, University “Magna Graecia,” Catanzaro 88100
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Tonesi D. Isolated hepatic tuberculosis: A disease of multifaceted presentations. Int J Mycobacteriol 2021;10:480
We read with great interest the fascinating case reported by Dhali et al. describing a case of Tuberculosis (TB) granulomatous hepatitis, without pulmonary or a disseminated involvement.
The authors properly point out that the patient presented with fluctuating jaundice, a condition not previously described.
Of more interest, Dhali et al. report that both ultrasound and computed tomography showed hepatomegaly of heterogeneous consistency, with no specific imaging features. Finally, only liver biopsy allowed the diagnosis of hepatic TB by showing caseous granulomas with Langhans giant cells.
The authors rightly highlight that fluctuating jaundice is a rare and not previously documented presentation of primary hepatic TB and may lead to diagnostic dilemmas.
We would like to add that this case further confirms the major diagnostic challenge of isolated hepatic TB, owing to its polymorphic presentation.
More frequently, this condition may present as an isolated focal hepatic lesion that lacking specific imaging features may be mistaken for other focal hepatic lesions, particularly primary liver cancers, as previously reported.,,,
Given that, when diagnosed correctly, it can have a positive outcome, and in view of the absence of specific imaging features, it is mandatory to take this diagnosis into account in patients with icteric hepatitis of unknown cause as well as in the differential diagnosis of isolated focal liver lesions.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Dhali A, Dhali GK, Ghosh R, Sarkar A. Primary tubercular granulomatous hepatitis presenting as fluctuating jaundice. Int J Mycobacteriol 2021;10:320-3.
] [Full text]
Yang C, Liu X, Ling W, Song B, Liu F. Primary isolated hepatic tuberculosis mimicking small hepatocellular carcinoma: A case report. Medicine (Baltimore) 2020;99:e22580.
Forgione A, Tovoli F, Ravaioli M, Renzulli M, Vasuri F, Piscaglia F, et al
. Contrast-enhanced ultrasound LI-RADS LR-5 in hepatic tuberculosis: Case report and literature review of imaging features. Gastroenterol Insights 2021;12:1-9.
Prabhudesai R, Lawande D, Gondal G, Keny S. Primary hepatic tuberculosis masquerading as intrahepatic cholangiocarcinoma. Indian J Tuberc 2019;66:310-3.
Kobayashi T, Ford B, Sekar P. Mycobacterium avium
-intracellulare (MAI) liver abscess mimicking liver metastasis in a patient with rheumatoid arthritis on adalimumab and methotrexate. BMJ Case Rep 2019;12:e230912.