Abdominal tuberculosis in Cairo, Egypt.

Twenty-two abdominal tuberculosis patients seen at Abbassia Fever Hospital in Cairo, Egypt from January 1990 to August 1992 are described; their mean age was 21.5 years, range 9-54 years; 17 were female. Common symptoms were fever, malaise, abdominal pain (64%) and weight loss (82%). Chest X-rays were normal in 14 patients (64%), but ultrasonography/computerized tomography of the abdomen was abnormal in 20 patients (91%), with adenopathy the usual finding. Anaemia and a raised erythrocyte sedimentation rate were present in all patients, and purified protein derivative skin test (5 Tu) was positive in 82%. Predominant abnormal physical findings were abdominal (86%), including hepatomegaly/splenomegaly and abdominal mass. Diagnosis was made from biopsy material (caseating granulomas) in 6 patients by laparotomy, 1 by laparoscopy, and 3 by cervical or supraclavicular node biopsy; and from laboratory examination of excretions in only 4 patients (acid-fast bacilli in stools of 2, mycobacteria in urine and menstrual fluid). Eight patients required presumptive diagnosis after response to specific isoniazid (+ethambutol) antituberculous therapy.