Intestinal tuberculosis

Γιουλεμέ, Όλγα; Paschos, Paschalis; Katsaros, Marios; Papalexi, Fani; Karabatsou, Sofia; Masmanidou, Maria; Koliouskas, Dimitrios

doi:10.1097/meg.0b013e32834a9470

Cited by 32 publications

(7 citation statements)

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“…[ 10 ] TST is widely used as an additional diagnostic tool for TB, but its usefulness is limited because of immune abnormalities in patients with ESRD undergoing dialysis. [ 12 ] Because active or past pulmonary TB is accompanied only in 25% of patients with extrapulmonary TB, intestinal TB cannot be excluded even if chest radiography results are negative. [ 3 ] In our case, abnormal findings suggestive of pulmonary TB scarring or active TB lesion were not found on the chest radiography.…”

Section: Discussionmentioning

confidence: 99%

Intestinal tuberculosis in a patient with end-stage renal disease on hemodialysis

Lee¹,

Kim²,

Kwon³

et al. 2020

Medicine

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Rationale: Intestinal tuberculosis (TB) is rarely seen in patients with end-stage renal disease (ESRD). We report an intestinal TB case with a clinical presentation similar to that of colon cancer in a patient with ESRD on hemodialysis. Patient concerns: A 49-year-old man presented with a 3-month history of general weakness and anorexia. He had been treated for stage 5 chronic kidney disease (CKD) due to diabetic nephropathy for the last 3 years. His blood urea nitrogen and serum creatinine levels were 96.9 and 8.1 mg/dL, respectively, at the time of admission; azotemia was accompanied by severe anemia, hypoalbuminemia, hyperkalemia, and metabolic acidosis. Hemodialysis was initiated for suspected exacerbation of uremia; however, intermittent fever, night sweats, and abdominal discomfort persisted. Diagnoses: Abdominal computed tomography (CT) and whole-body 18 F-fluorodeoxyglucose positron emission tomography were indicative of ascending colon cancer with lymph node metastases. However, colonoscopy with biopsy revealed the formation of submucosal caseating granuloma and acid-fast bacillus. Interventions: We initiated quadruple therapy with isoniazid, rifampicin, pyrazinamide, and ethambutol. The patient continued the quadruple regimen for the first 2 months before switching to dual therapy and received anti-TB medications for a total of 12 months. Outcomes: After 9 months of standard anti-TB chemotherapy, polypoid residual lesions were noted during follow-up colonoscopy. Laparoscopy-assisted ileocecal resection was performed. No findings suggestive of recurrence of colonic TB were observed on follow-up abdominal CT at 6 months after discontinuation of anti-TB medications. Lessons: If non-specific uremic symptoms persist in patients with advanced CKD, the possibility of extrapulmonary TB such as intestinal TB must be considered. Also, in patients with radiologic suspicion of colon cancer, endoscopy with biopsy should be performed promptly to exclude colonic TB with similar clinical manifestations.

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Section: Discussionmentioning

confidence: 99%

Intestinal tuberculosis in a patient with end-stage renal disease on hemodialysis

Lee¹,

Kim²,

Kwon³

et al. 2020

Medicine

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“…Few reported cases have described an ulcer or mass being caused by Mycobacterium Tuberculosis close to the gastro-oesophageal junction 2 . Primary tuberculosis of the stomach has been characterised by haematemesis, a non-healing ulcer or perforation with or without fever, 3 in association with pulmonary tuberculosis or immunoincompetent patients 4 . This case is distinctive and unusual as our patient had primary isolated gastric tuberculosis in the absence of pulmonary tuberculosis in an otherwise healthy individual.…”

Section: Discussionmentioning

confidence: 99%

Non-healing gastro-duodenal ulcer: A rare presentation of primary abdominal tuberculosis

Merali

Chandak

Doddi

et al. 2015

International Journal of Surgery Case Reports

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HighlightsThis case has illustrated the difficulty of promptly diagnosing an unusual case of primary duodenal tuberculosis from chronic peptic ulcer disease, in the absence of pulmonary involvement in an immunocompetent patient.A high index of clinical suspicion with a multidisciplinary team approach is required.The first line of treatment for gastrointestinal tuberculosis is medical treatment, indicating that 6 months of an anti-tuberculosis regime is satisfactory. Surgical treatment should be sought for patients who develop complications such as obstruction, perforation, and stricture formation.In the absence of positive pathological (polymerase chain reaction or acid-fast bacilli staining) and radiologic tests, the diagnosis is often established by obtaining a surgical histopathology specimen.

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“…Despite the above, the diagnosis of TB colitis can remain uncertain ( 20 ). For situations in which there is high index of suspicion of TB on clinical grounds, anti-TB therapy is appropriate.…”

Section: Discussionmentioning

confidence: 99%