Steroids are indicated in all of the following complicatons of tuberculosis except –
Correct Answer: Ileo-Caecal tuberculosis
Description: ILEOCECAL TUBERCULOSIS. Primary tuberculosis of the bowel is rare. When it does occur, it is more commonly found in young people under 18 than in older people; and is due, we assume, to ingestion of milk, butter or meat from tuberculous cows. Although intestinal TB is not an uncommon form of extrapulmonary TB, ileocecal TB remains a diagnostic challenge and often ends in the surgical wards as acute abdomen. The patients usually present with abdominal pain, weight loss, fever, anorexia, change in bowel habits, nausea and vomiting Treatment: T-cell spot of TB test (T-SPOT.TB) (Oxford Immunotec, Abingdon, UK), which detects interferon-g response to MTB-specific antigens encoded in the region of difference 1 (RD1) region, has been developed as a sensitive, specific, and rapid immunodiagnostic test for TB infection in recent years. T-SPOT.TB is an enzyme-linked immunospot assay performed on separated and counted peripheral blood mononuclear cells (PBMCs). The result is repoed as the number of interferon-g producing T-cells (spot-forming cells ). There were 34 (34/42, 81.0%) T-SPOT.TB-positive cases in this study with a median antigen-specific interferon-g secreting T-cells count of 370 (interquaile range 70-1252) SFCs/106 PBMC. The purified protein derivatives (PPD) test positive rate was only 52.5% (32/61). Both T-SPOT.TB and PPD tests were performed in 26 patients: 20 (76.9%) positive T-SPOT.TB and 13 (50.0%) positive PPD were detected, with statistical significant difference (P = 0.046). Elevated C-reactive protein, elevated erythrocyte sedimentation rate, hypoalbuminemia, and anemia were the most common laboratory abnormalities Ref Harrison20th edition pg 1017
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