A Case of Intestinal Tuberculosis Mimicking Crohn’s Disease: A Clinical and Diagnostic Dilemma

Abstract

This case highlights the importance of differentiating between Crohn’s disease and intestinal tuberculosis. The rates of misdiagnosis of Crohn’s disease and intestinal tuberculosis range from 50% to 70% because of their non-specific and clinically similar manifestations.If intestinal tuberculosis is misdiagnosed as Crohn’s disease, use of immunomodulatory drugs commonly used for Crohn’s disease can increase the risk of disseminated tuberculosis. Here we present a case highlighting the clinical similarity between these two distinct medical conditions and suggest how a similar scenario can be approached, which can help to differentiate between the two otherwise very similar conditions.

Mistaken identity: Reporting two cases of rare forms of extrapulmonary tuberculosis in Solomon Islands

“…Misdiagnosis was an important factor that delayed treatment in the cases presented above. Importantly, misdiagnosis of rare forms of EPTB occurs in both developing and developed nations [ [17] , [18] , [19] ]. EPTB infection in organs with a high normal burden of bacterial flora, like the colon, can be particularly difficult to diagnose as samples may culture pathogenic bacteria that disguise the mycobacterial tuberculosis infection, delaying diagnosis.…”

Acute intestinal obstruction: What if it is instead colonic tuberculosis? What diagnostic and management dilemmas are there?

“…From the moment that one of the pathologies is suspected, a whole series of complementary investigations based essentially on endoscopic and radiological assessments must be performed. However, confirmation is based on histological evidence [ 17 ]. Therefore, clinicians should suspect colonic tuberculosis, in patients with abdominal symptoms from endemic countries of tuberculosis in order to prevent complications caused by delayed and underestimated diagnosis.…”