Abdominopelvic Tuberculosis Secondary to a Nontuberculous Mycobacterium in an Immunocompetent Patient

Research output: Contribution to journalArticle

Abstract

Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient. We report a case of NTM in abdominopelvic TB. A 37-year-old foreign worker, para 3, presented with a one-week history of suprapubic pain associated with fever. An assessment showed presence of a right adnexal mass. She was treated as tuboovarian abscess with intravenous antibiotics. Unfortunately, she did not respond. She underwent exploratory laparotomy. Intraoperatively, features of the mass were suggestive of a right mature cystic teratoma with presence of slough and cheesy materials all over the abdominal cavity as well as presence of ascites. Diagnosis of NTM was confirmed with PCR testing using the peritoneal fluid. This case was a diagnostic dilemma due to the nonspecific clinical presentation. Management of such rare infection was revisited.

Original languageEnglish
Article number9016782
JournalCase Reports in Medicine
Volume2017
DOIs
Publication statusPublished - 13 Nov 2017

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Nontuberculous Mycobacteria
Tuberculosis
Teratoma
Nontuberculous Mycobacterium Infections
Abdominal Cavity
Ascitic Fluid
Ascites
Laparotomy
Abscess
Signs and Symptoms
Cause of Death
Fever
Anti-Bacterial Agents
Pain
Polymerase Chain Reaction
Incidence
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Abdominopelvic Tuberculosis Secondary to a Nontuberculous Mycobacterium in an Immunocompetent Patient",
abstract = "Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20{\%} of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient. We report a case of NTM in abdominopelvic TB. A 37-year-old foreign worker, para 3, presented with a one-week history of suprapubic pain associated with fever. An assessment showed presence of a right adnexal mass. She was treated as tuboovarian abscess with intravenous antibiotics. Unfortunately, she did not respond. She underwent exploratory laparotomy. Intraoperatively, features of the mass were suggestive of a right mature cystic teratoma with presence of slough and cheesy materials all over the abdominal cavity as well as presence of ascites. Diagnosis of NTM was confirmed with PCR testing using the peritoneal fluid. This case was a diagnostic dilemma due to the nonspecific clinical presentation. Management of such rare infection was revisited.",
author = "Ng, {Beng Kwang} and Yakob, {Kembang Aziah} and Ng, {Wendy Yin Ling} and Lim, {Pei Shan} and {Abd Rahman}, Rahana and {Abdul Karim}, {Abdul Kadir} and Zainuddin, {Ani Amelia} and {Abdullah Mahdy}, Zaleha",
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AU - Ng, Beng Kwang

AU - Yakob, Kembang Aziah

AU - Ng, Wendy Yin Ling

AU - Lim, Pei Shan

AU - Abd Rahman, Rahana

AU - Abdul Karim, Abdul Kadir

AU - Zainuddin, Ani Amelia

AU - Abdullah Mahdy, Zaleha

PY - 2017/11/13

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