Abdominal tuberculosis: a descriptive case series of the experience in a Canadian tuberculosis clinic

Objective To describe the experience with abdominal tuberculosis (TB), including potential risk factors, presentation, diagnosis, treatment and clinical course, at one Canadian clinic. Design This was a retrospective case series of all patients with abdominal TB (excluding the genito-urinary system and abdominal muscle) who received care at the Saint Michael's Hospital TB Clinic (Toronto, ON, Canada) from April 2003 to July 2016. Results Of 590 active TB cases encountered between April 2003 and July 2016, 24 (4.1%) had abdominal TB. All cases were foreign-born, and over 50% occurred among individuals who were not recent immigrants. Background abdominal illnesses and immunocompromised health status were rarely seen. Lymphadenitis (58.3%) and the peritoneum (41.7%) were the most common forms of abdominal TB, bowel involvement was infrequent and most had concomitant extra-abdominal disease (62.5%). All cases were cured, largely using ⩾9 months of pharmacotherapy. Gastrointestinal intolerance and liver dysfunction were rarely observed side effects of therapy. Conclusions Several traditional TB risk factors occurred infrequently among our cases, which highlights the importance of having a low threshold for considering abdominal TB in the appropriate clinical setting. Although abdominal TB often occurred in the context of disseminated disease, cure was achievable, but ⩾9 months of treatment may generally be needed.