Case of intestinal tuberculosis mimicking Crohn’s disease

Foster, Brandon; Buchberg, Brian; Parekh, Nimisha K.; Mills, Steven

doi:10.12659/ajcr.882756

Cited by 10 publications

(14 citation statements)

References 19 publications

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“…In these cases, the initial symptoms include abdominal pain, 1 – 17 diarrhea, 1 , 2 , 4 , 7 – 9 , 11 , 12 , 14 , 17 – 20 weight loss, 1 , 4 , 7 , 9 – 11 , 13 – 19 fever, 2 , 3 , 6 – 9 , 11 , 13 , 16 , 17 , 19 hematochezia, 5 , 18 , 21 , 22 anorexia, 1 , 6 , 10 , 14 , 15 , 17 vomiting, 1 , 7 , 10 , 15 , 17 intestinal obstruction, 3 , 6 and dyspnea. 2 The abdominal physical examinations were normal or not described in most cases.…”

Section: Resultsmentioning

confidence: 99%

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Wei

Wu²,

Gao³

et al. 2016

Medicine

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The differential diagnosis of Crohn's disease (CD) and intestinal tuberculosis (ITB) remains difficult as the clinical symptoms of the 2 digestive diseases are so similar. Here we report a case where a patient was initially misdiagnosed with ITB prior to the correct CD diagnosis. The 46-year-old male patient was hospitalized elsewhere for pain in the right lower abdomen and underwent an appendectomy. The pathological diagnosis was ITB and the patient was administered antituberculosis therapy for 1 year. Afterward, the patient was readmitted to the hospital for a right lower abdominal mass. A computed tomography scan revealed intestinal gas, fistula, and abdominal mass. We performed a right hemicolectomy on the patient. Postoperatively, we diagnosed the patient with CD, based on patient history and pathological examination. According to the CD active index (CDAI), the patient was at high risk and began treatment with infliximab. The patient has remained in complete remission and made a good recovery after 8-months follow-up. We compared this case with the results of a literature review on the misdiagnosis between CD and ITB (26 previously reported cases) to determine the characteristics of misdiagnosed cases. We found that distinguishing between ITB and CD is difficult because of their varied clinical presentation, nonspecific investigative tools, and profound similarities even in pathological specimens. Although a CT scan to determine the morphology of the bowel wall is a key for correct diagnosis, each case still poses challenges for diagnosis and administrating the appropriate treatment.

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Section: Resultsmentioning

confidence: 99%

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Wei

Wu²,

Gao³

et al. 2016

Medicine

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“…Demuestra el desarrollo de TB en el estó-mago, es una persona no inmunocomprometida 4 . Aunque la TBGI es relativamente poco común en los países desarrollados, su incidencia ha aumentado considerablemente durante las últimas décadas, debido, principalmente, a la infección por VIH, la pobreza, el deterioro de las condiciones sociales y la inmigración 5,6 .…”

Section: Discussionunclassified

“…El diagnóstico diferencial de la TB gástrica y el cáncer gástrico es difícil de establecer por las características endoscópicas que ambas comparten, así como diferenciar la enfermedad de Crohn de la TB intestinal y colónica es un dilema para médicos y patólogos al ser ambos trastornos con inflamación granulomatosa crónica con características clínicas similares 4 . Presentamos un caso de una paciente con TB gástrica, en la que el paciente presenta cambios de comportamiento.…”

Section: Introductionunclassified

Tuberculosis gástrica que simula otra patología: caso clínico

Carvajal¹,

Toro²,

Coutin³

et al. 2015

MedUPB

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RESUMENLa tuberculosis gástrica es una entidad rara que simula otras patologías. Suele asociarse con diagnósticos tardíos debido a sus características clínicas y forma de presentación atípica en este tipo de órganos. Se extrajeron los datos de la historia de una paciente, previo consentimiento informado. Se describen las características clínicas, el enfoque inicial, los hallazgos endoscópicos y la similitud con otras patologías, para terminar con una revisión del tema en la literatura. La tuberculosis gástrica simuló, inicialmente, otras patologías, lo que generó retraso y algunas dificultades en el diagnóstico y manejo. Se trata de una entidad con manifestaciones clínicas variables e inespecíficas, que se confunden con otras entidades, dada su similitud clínica y poca frecuencia de presentación. Existe poca literatura y la mayoría se limita a reportes de casos aislados, con comportamiento benigno y respuesta adecuada al manejo médico con fármacos antituberculosos. Palabras clave: tuberculosis; diagnóstico diferencial; endoscopia; estomago; intestino delgado; intestino grueso. ABSTRACTGastrointestinal tuberculosis is a rare entity that mimics other pathologies. It is commonly associated with late diagnosis due to its clinical characteristics and atypical presentation in these types of organs. Data were taken from the medical record of a patient following informed consent. Clinical characteristics, initial focus, endoscopic findings, and similarities with other pathologies are described, and a topic review was done. Initially, gastric tuberculosis mimicked other pathologies causing a delay and difficulty to issue correct diagnosis and treatment. This entity has variable and nonspecific clinical manifestations which can be confused with other entities due to clinical similarities and infrequent presentation. There is scarce literature and most is limited to isolated case reports with benign behavior and adequate response to TB treatment.

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“…9 Diagnosis TB usus merupakan hal yang menantang bagi klinisi karena manifestasi klinis yang beragam sehingga menyerupai penyakit infeksi lain, autoimun, keganasan dan terkait zat iritan (kasusnya jarang). 3,10 Kurang dari 25% pasien dengan TB gastrointestinal juga memiliki infeksi TB pada paru. 3,4 Dengan demikian, diagnostik yang cepat dan akurat sangat penting agar tatalaksana pasien dapat optimal.…”

Section: Pendahuluanunclassified

“…18 Pemeriksaan PCR harus selalu dilakukan jika tersedia, namun hasil negatif tidak menyingkirkan diagnosis TB intestinal. 10 Terdapat publikasi peran Xpert MTB/ Rifampicin dalam deteksi M. tuberculosis dari spesimen feses pada pasien TB paru. 28 Namun, perannya dalam deteksi TB intestinal tidak banyak dibahas.…”

Section: Laboratorium Penunjangunclassified

Pendekatan Diagnosis dan Tatalaksana Tuberkulosis Intestinal

Murwaningrum¹,

Abdullah²,

Makmun³

2017

JPDI

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ABSTRAKTuberkulosis (TB) telah menjadi masalah global yang terus membesar seiring dengan bertambahnya jumlah pasien TB. Infeksi TB masih merupakan hal yang umum ditemukan dan merupakan faktor penting terhadap angka kesakitan dan kematian, terutama pada negara yang belum dan sedang berkembang. Kasus Tuberkulosis usus (TB usus) juga meningkat seiring dengan meningkatnya jumlah kasus TB secara umum. Indonesia merupakan Negara ke-2 dengan prevalensi Tuberkulosis TB tertinggi di Asia Tenggara setelah Timor Leste pada tahun 2014. TB usus adalah manifestasi TB ekstrapulmonal terbanyak keenam.Manifestasi klinis yang tidak spesifik dan kadang menyerupai beberapa kondisi lain termasuk keganasan menyebabkan diagnosis TB usus sulit ditegakkan secara akurat. Temuan dari hasil endoskopi dan gambaran radiologi dari berbagai stage penyakit sudah sangat banyak, namun diagnosis tetap sulit dilakukan. Sampai saat ini belum ada metode tunggal yang dapat mendeteksi TB usus secara tepat dan akurat, berbagai metode investigasi telah digunakan dalam diagnosis TB usus. Diagnosis yang dilakukan sejak awal, pemberian terapi anti tuberculosis dan tindakan bedah adalah hal-hal esensial dalam pencegahan terjadinya kesakitan dan kematian akibat TB usus, sehingga dibutuhkan kombinasi penilaian klinis dan pemeriksaan berbagai modalitas. Pasien yang telah didiagnosis TB usus diberikan terapi obat anti tuberculosis (OAT) dan pertimbangan tindakan bedah jika mengalami komplikasi. Kata Kunci: diagnosis, tuberkulosis intestinal ABSTRACT Tuberculosis (TB) has become a resurgent global problem with increasing numbers of patients. TB infection is still common and remains an important cause of morbidity and mortality, particularly in underdeveloped and developing nations. Intestinal tuberculosis (intestinal TB) rates are rising, consistet with the overall trend. In 2014 Indonesia has the second highest TB prevalence in South East

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Case of intestinal tuberculosis mimicking Crohn’s disease

Cited by 10 publications

References 19 publications

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Tuberculosis gástrica que simula otra patología: caso clínico

Pendekatan Diagnosis dan Tatalaksana Tuberkulosis Intestinal

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