Tuberculosis symptoms are easily confused with digestive diseases.

A 20-year-old female patient had prolonged fever, abdominal pain, loss of appetite, and digestive disorders. Examination revealed peritoneal tuberculosis with more than 2 liters of fluid in the abdomen.

The patient, who lives in Lam Dong, came to the hospital with a fever, chills that lasted for a week, pain in the pelvic area, nausea, loss of appetite but slight weight gain. According to the patient, she had previously been admitted to a hospital near her home, the doctor diagnosed enteritis, suspected intestinal tuberculosis but ordered continued monitoring.

Illustration photo.

The results of the examination, ultrasound, and computed tomography (CT) scan showed that the patient had fluid in the abdomen. The patient was ordered to have the fluid aspirated for diagnostic testing. The aspirated fluid was about 2 liters, light yellow in color. This was the reason why the patient gained weight despite showing signs of loss of appetite and nausea. After the fluid was aspirated, the patient's symptoms initially subsided.

According to doctors, the diagnosis process is difficult because peritoneal effusion has many causes. Initial test results of peritoneal fluid suggest peritoneal tuberculosis.

The PCR test for tuberculosis (Polymerase Chain Reaction) was negative. The CA125 index (a cancer marker present at high concentrations in the blood when there are tumor cells) increased 10 times compared to normal people (about 35 U/ml).

This index increases in both tuberculosis and cancer peritoneal fluid, so the possibility of cancer cannot be ruled out. The treatment regimen for these two conditions is very different. Therefore, the doctor orders the patient to undergo a peritoneal biopsy to accurately diagnose the cause.

The doctor performed an exploratory laparoscopic surgery, took peritoneal tissue for pathological anatomy, the patient had a condition of necrotizing granulomatous inflammation due to tuberculosis (peritoneal tuberculosis).

This is one of the severe forms of tuberculosis. After determining the exact cause of abdominal pain and ascites is peritoneal tuberculosis, the patient is treated for tuberculosis at a hospital with a tuberculosis department.

According to specialist doctor Hoang Manh Chinh, Center for Endoscopy and Digestive Endoscopic Surgery, Tam Anh General Hospital, Ho Chi Minh City, peritoneal tuberculosis is an inflammatory lesion of the peritoneum caused by tuberculosis bacteria, often appearing secondary to pulmonary tuberculosis.

Depending on the toxin, the number of tuberculosis bacteria and the body's immune system, different symptoms will appear, which can be loud or faint. Common symptoms are fever in the afternoon; abdominal pain, abdominal distension and gradual enlargement due to fluid in the abdomen; in the late stages, it can cause intestinal obstruction or partial intestinal obstruction.

These symptoms can easily be confused with other digestive diseases such as appendicitis, intestinal obstruction, peritonitis due to causes other than tuberculosis, primary or secondary peritoneal cancer after colon or ovarian cancer, etc.

Therefore, Dr. Phat recommends that when seeing the abdomen increase in size rapidly, abdominal pain, nausea, feeling full quickly after eating and suspecting abdominal effusion, the patient needs to go to a medical facility immediately to be examined for abdominal effusion.

If there is ascites, the patient needs to do specialized tests to determine the exact cause of the fluid in the abdomen.

In case of tuberculosis, the patient will be treated with medication according to the Ministry of Health's tuberculosis treatment regimen. However, if the disease is detected at a late stage and complications appear, the patient will need surgical intervention.

According to statistics from the health sector, Vietnam is one of the countries with the highest number of tuberculosis patients and drug-resistant tuberculosis patients in the world. Every year, our country has over 10,000 deaths caused by tuberculosis.

Regarding the application of science and technology in the diagnosis and treatment of pulmonary tuberculosis, according to Associate Professor, Dr. Nguyen Binh Hoa, Deputy Director of the Central Lung Hospital, Vietnam is currently applying artificial intelligence (AI) in detecting tuberculosis.

Artificial intelligence applications are attached to X-ray machines, according to the guidelines of the World Health Organization, the machine will have software to support reading X-ray films.

AI will help doctors find patients suspected of having tuberculosis based on lesions, from which doctors will prescribe more accurate tuberculosis bacteria tests.

The National Tuberculosis Control Program has deployed AI in case detection in many provinces and cities since 2021. Thanks to AI, the efficiency of tuberculosis detection has doubled.

According to statistics, the rate of tuberculosis detection between medical facilities that implemented AI and medical facilities that did not implement AI doubled. Even comparing the time before and after implementing AI at a medical facility, the number of tuberculosis cases detected also increased significantly.

In district-level medical facilities, remote areas, where there is a shortage of tuberculosis specialists, the artificial intelligence system will be effective in early detection of tuberculosis in the community.

Currently, the need for artificial intelligence systems in tuberculosis detection is huge, however, funding for installing this system is limited.

If Vietnam widely deploys artificial intelligence technology in early detection of tuberculosis, it will contribute to ending tuberculosis and improving people's health.

According to the World Health Organization, globally, tuberculosis caused an estimated 1.3 million deaths in 2022. This is down from the previous national TB program estimate of 1.4 million in 2020 and 2021, and almost back to the 2019 death toll.

An estimated 10.6 million people will have TB in 2022, up from the National Tuberculosis Control Program's previous estimate of 10.3 million in 2021 and 10.0 million in 2020.

Global TB eradication remains a challenge and requires more efforts from countries, especially to turn the commitments made at the 2023 UN High-Level Meeting on TB into concrete actions.

Vietnam is still a country with a high burden of tuberculosis, ranking 11th among the 30 countries with the highest number of tuberculosis patients globally, and also ranking 11th among the 30 countries with the highest burden of multidrug-resistant tuberculosis in the world (WHO Global TB Report 2023).

In 2023, the National Tuberculosis Control Program estimates that each year Vietnam will have 172,000 new cases of TB and about 13,000 deaths from TB, higher than the number of deaths from traffic accidents.

Every year, our country has about 9,200 new cases of multidrug-resistant tuberculosis, accounting for 4.5% of new tuberculosis patients and 15% of those who have been treated.

Compared to the North and Central regions, the tuberculosis epidemic in the South is much more severe, especially in the provinces of the Southwest region with about 400 to 500 tuberculosis cases per 100,000 people.

Although the tuberculosis epidemic in Vietnam is still very serious, the number of tuberculosis patients detected, treated and reported annually in Vietnam only accounts for about 60% of the estimated number of tuberculosis patients (in 2023, 106,086 tuberculosis patients of all types were detected). Thus, nearly 40% of tuberculosis patients in the community have not been detected and treated or reported.

Source: https://baodautu.vn/de-nham-lan-trieu-trung-cua-benh-lao-voi-cac-benh-tieu-hoa-d225110.html