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838 Abdominal Tuberculosis Due to Mycobacterium Bovis
  1. G Lozano Sánchez,
  2. E Núñez Cuadros,
  3. D Moreno Pérez,
  4. VM Candón Moreno,
  5. B Carazo Gallego,
  6. A Urda Cardona
  1. Paediatric, Hospital Carlos Haya, Málaga, Spain

Abstract

Background Currently, disease related to Mycobacterium bovis (MB) is rare in Spain (less than 1% of tuberculosis cases). However, it’s more frequent in undeveloped countries where the way to become infected is usually by raw milk consumption.

Methods We describe the epidemiologic, clinical and therapeutic characteristics of 5 patients with abdominal tuberculosis due to MB.

Results Five children (3 male) emanating from Morocco with ages between 2 and 6 years, all of them had fever, abdominal pain and constitutional syndrome. Three of them used to drink raw goat’s or cow’s milk. In 2 cases tuberculin skin test was over than 12 mm. There was open surgery (3) or laparoscopy (2) for realization of lymph node biopsy or drainage of abscess. The diagnosis was through culture and PCR in drained material and/or lymph node. Associated complications were: intraabdominal bacterial infection (4), esteroraceus fistula (2), intestinal occlusion (3). All patients were immunocompetent, except one case with histocompatibility complex class II molecules deficiency. Empirical treatment consisted in isoniazid and rifampicin for 6 months, amikacin (3) or ethambutol (2) during 1 or 2 months respectively. One patient developed a Dress syndrome related to rifampicin. All patients received antituberculous drugs during 6 months, except two patients who needed extended therapy.

Conclusion Treatment for abdominal tuberculosis must be medical, and surgery should be used only in serious complications or biopsy. Although the clinical presentation is often very similar from the produced by M. tuberculosis, empirical therapy avoiding pyrazinamide should be started if MB is suspected.

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