obsolete tuberculous mesenteric gland

Obsolete Tuberculous Mesenteric Glands

The description of obsolete tuberculous mesenteric glands refers to the condition where these glands become caseating and enlarged due to tuberculosis infection [1]. In this state, the mesenteric glands are usually an isolated tuberculous infection, resulting from infection from the bowel. Notably, in such cases, no trace of tuberculous ulceration is found [4].

Characteristics

• The mesenteric glands become caseating and enlarged.
• This condition is often an isolated tuberculous infection.
• It results from infection from the bowel.
• No trace of tuberculous ulceration is present.

Clinical Significance

The description of obsolete tuberculous mesenteric glands highlights a specific manifestation of tuberculosis in the abdominal region. Understanding this condition can aid in diagnosing and managing patients with extrapulmonary tuberculosis (EPTB).

References: [1] - A child, aged 11, was admitted with similar clinical symptoms [2]. [4] - In such cases no trace of tuberculous ulceration is found. [3] - The caecum was thick, stiff with extreme narrowing of the lumen and covered with excess of mesenteric fat.

Common Clinical Presentations

The most common clinical presentation of obsolete tuberculous mesenteric glands includes:

• Pain abdomen
• Weight loss
• Anorexia (loss of appetite)
• Fever
• Chronic diarrhea
• Vomiting

These symptoms are often accompanied by other signs such as abdominal distension, liver and spleen being impalpable, and a weakly positive Chvostek's sign.

Other Possible Symptoms

Compression of adjacent organs by the enlarged nodes may lead to additional symptoms, including:

• Dysphagia (difficulty swallowing) due to esophageal compression

Based on the provided context, it appears that diagnostic tests for obsolete tuberculous mesenteric gland are challenging and not well-established.

• The Mantoux test has low sensitivity and specificity, making it unreliable for diagnosis [1].
• A complete urinalysis, stool examination, haemogram, and serum protein estimation may be performed as part of a thorough physical examination, but these tests do not specifically diagnose tuberculous mesenteric gland [3].
• Fine-needle aspiration cytology (FNAC) has emerged as a simple outpatient diagnostic method for gastrointestinal tuberculosis, including mesenteric gland involvement [6]. However, its effectiveness in diagnosing obsolete tuberculous mesenteric gland is unclear.
• Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) may help diagnose lymphadenopathy, which can be associated with tuberculous mesenteric gland. However, imaging results alone may not be sufficient to diagnose this condition [7].
• A serologic test for diagnosing active TB, such as the nucleic acid amplification (NAA) test, is available but its effectiveness in diagnosing obsolete tuberculous mesenteric gland is unknown.
• Demonstration of Acid-Fast Bacilli (AFB) in tissue sections is a definitive diagnostic method for tuberculosis. However, AFB positivity ranges from 5% to 40.5%, and the absence of AFB does not exclude TB [15].

In summary, there are limited diagnostic tests available for obsolete tuberculous mesenteric gland, and most of these tests have limitations in terms of sensitivity and specificity. Further research is needed to establish effective diagnostic methods for this condition.

References: [1] Context 1 [3] Context 3 [6] Context 6 [7] Context 7 [15] Context 15

Based on the provided context, it appears that there isn't much information available on the specific topic of "obsolete tuberculous mesenteric gland" and its treatment with drugs.

However, I can provide some general information on tuberculosis (TB) treatment. TB is a bacterial infection caused by Mycobacterium tuberculosis that primarily affects the lungs but can also affect other parts of the body, including the lymph nodes, such as the mesenteric glands.

The standard treatment for drug-susceptible tuberculosis involves a combination of four drugs: isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EM

The differential diagnosis for patients suspected to have obsolete tuberculous mesenteric gland involvement includes several conditions that can mimic the symptoms and presentation of TB.

• Lymphomas: These are cancers that affect the lymphatic system, which can cause enlargement of the mesenteric glands.
• End-stage liver diseases: Liver cirrhosis or other severe liver conditions can lead to ascites (fluid accumulation in the abdominal cavity) and enlargement of the mesenteric glands.
• Spontaneous bacterial peritonitis: This is a condition where bacteria infect the fluid accumulated in the abdominal cavity, leading to inflammation and enlargement of the mesenteric glands.

These conditions can present with similar symptoms to tuberculous mesenteric gland involvement, such as ascites, weight loss, and fever. Therefore, it's essential to consider these differential diagnoses when evaluating patients with suspected TB.

In addition to these conditions, other factors that may contribute to the differential diagnosis include:

• Crohn disease: This is a type of inflammatory bowel disease (IBD) that can cause inflammation in the mesenteric glands and lead to symptoms similar to those seen in TB.
• Amebiasis: This is an infection caused by the parasite Entamoeba histolytica, which can lead to inflammation and enlargement of the mesenteric glands.

To accurately diagnose obsolete tuberculous mesenteric gland involvement, it's crucial to consider these differential diagnoses and perform a thorough evaluation, including imaging studies and laboratory tests.