파종결핵에서 급성 간염은 그 빈도가 매우 드물고 간조직 생검을 필요로 하기 때문에 초기에 간과되기 쉽다. 저자들은 급성간염으로 내원한 환자에서 파종결핵을 진단하고 결핵치료를 통해 간염을 치료한 1예를 경험하였기에 보고한다.
Involvement of the liver is very common in military tuberculosis, but despite this fact, jaundice and hepatocellular dysfunction very rarely occur in this disease. Here, we report the case of a 59-year-old male patient who presented with acute hepatitis. After being admitted for fever and right upper quadrant pain for a 3-day period, military tuberculosis was diagnosed and treated with anti-tuberculosis medication. Despite treatment, which was based on laboratory results and radiologic findings suggestive of acute hepatitis, fever persisted, jaundice developed, and hepatic enzyme levels increased. Percutaneous liver biopsy was performed to assist in the differential diagnosis of acute hepatitis and findings from the biopsy specimen revealed typical hepatic tuberculosis. Antituberculosis treatment was initiated, and the fever gradually subsided and hepatic enzyme levels decreased. (Korean J Med 76:627-631, 2009)