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Table 5 Traditional and updated diagnostic criteria for hepatic TB

From: A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection

Diagnostic criteria in 1984 [18] Updated diagnostic criteria in 2014*
• Acid fast bacilli on smear of liver tissue • Culture of liver tissue demonstrating M. tuberculosis
• Culture of liver tissue demonstrating M. tuberculosis • Acid fast bacilli on smear or nucleic acid (PCR) positive for TB (IS6110 insertion sequence) from liver tissue sample
• Caseating hepatic granulomata with a positive Mantoux reaction • Abdominal CT demonstrating low-density hepatic nodule(s) (<2 mm: miliary; >2 mm: local) in patient with confirmed pulmonary TB or in a TB-endemic region
• Hepatic granulomata with demonstration of TB bacilli anywhere else in the patient • Clinical presentation of right upper quadrant pain, hepatomegaly, fever, and weight loss in patient with confirmed pulmonary TB or in a TB-endemic region**
• Typical appearance at laparotomy • Resolution of elevated liver enzymes following anti-TB therapy
• Autopsy confirmation of hepatic TB
• Response to specific therapy
  1. TB = Tuberculosis; PCR = Polymerase chain reaction; CT = Computed tomography.
  2. *Diagnostic criteria are presented from the strongest evidence to the weakest evidence.
  3. **When available, other diagnostic tools such as radiography and liver biopsy should be employed to confirm clinical diagnosis.