Table 5 Traditional and updated diagnostic criteria for hepatic TB
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 |