Intracranial Tuberculomas in a Nonimmuncompromised Patient with Abdominal Tuberculosis Misdiagnosed as Crohn’s Disease

Başar, Ömer; Köklü, Seyfettin; Köksal, Deniz; Köksal, Aydın Şeref; İbi̇ş, Mehmet; Uçar, Engin; Ülker, Aysel

doi:10.1007/s10620-005-2772-9

Cited by 4 publications

(8 citation statements)

References 14 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%

“…These data indicated that discriminating between ITB and CD is especially difficult because the clinical presentation is equivocal and nonspecific, and the diagnostic value of the clinical features is not high. The laboratory features mainly included anemia, 1 , 2 , 9 – 12 , 16 , 18 , 19 raised erythrocyte sedimentation rate (ESR), 4 , 9 , 12 , 17 – 19 and raised C-reactive protein (CRP). 4 , 14 , 18 , 19 Other laboratory features were normal or not described.…”

Section: Resultsmentioning

confidence: 99%

“…The CT imaging morphology findings can be summarized as follows: segmental and irregular thickening of the involved bowel, 1 , 4 , 6 , 8 , 9 , 11 , 12 , 14 , 16 , 22 , 23 enlarged lymph nodes, 4 , 8 , 12 , 14 , 23 fistula, 18 and ascites. 14 However, none of these findings could be used to distinguish CD from ITB.…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, almost all ITB patients were associated with normal chest radiographs. Among the colonoscopy features, pseudopolyps 1 , 2 , 5 , 9 , 11 , 19 and ulcerative lesions 1 , 2 , 4 – 6 , 9 , 10 , 12 , 14 , 15 , 17 – 20 , 23 were the most common reasons for misdiagnosis. Other reasons included exudates, 2 , 4 nodularity, 2 , 16 , 17 cobblestone mucosa, 4 and skip areas of inflammation and ulceration.…”

Section: Resultsmentioning

confidence: 99%

“…Twelve patients (44.4%) received CD-related drugs as the initial treatment, 9 patients were given corticosteroids 1 , 2 , 7 , 10 , 14 , 15 , 17 – 19 , 23 , 24 (methylprednisolone and prednisone), 1 patient was given azathioprine, 1 , 14 7 patients were discharged with 5-aminosalicylic acid (5-ASA), 2 , 9 – 12 , 14 , 15 , 18 , 24 1 patient was given budesonide. 11 After failure of corticosteroid treatment, 6 patients received surgical treatment.…”

Section: Resultsmentioning

confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Wei

Wu²,

Gao³

et al. 2016

Medicine

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Multiple tuberculomas in an immunocompetent patient and their diagnostic challenge in a high prevalence country: Case report and literature review

Velásquez-Rimachi

Orellana-Tovar²,

Rodriguez-López³

et al. 2020

Indian Journal of Tuberculosis

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A Patient with Crohn’s Disease Presenting with a Picture Mimicking a Strangulated Incisional Hernia: A Case Report

Alshahrani

2023

MEWFM

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Objective: To report a case of Crohn’s disease that presented with a clinical picture mimicking a strangulated incisional hernia. Case Report: A 33-year-old Saudi male patient presented to the Emergency Department (ED) with vomiting, pain, and swelling at the right iliac fossa after lifting heavyweight objects two days earlier. The patient had a past history of appendectomy through a transverse incision nine years earlier. Clinically, the patient was vitally stable. He had tenderness at the right iliac fossa, and rebound tenderness. A tender swelling (6 x 8 cm) was observed underneath the previous scar. It was firm, not expansile on cough, and not reducible, with no redness or skin changes. The laboratory report showed normal results for complete blood count, apart from slight leukocytosis. Blood electrolyte levels, renal and liver function tests were normal. Plain CT abdomen showed a defect in the transversus abdominis muscle with the presence of swelling beneath the oblique muscles associated with air, which were connected to the bowel. The preliminary diagnosis was a “strangulated incisional hernia”. After laparotomy, the swelling showed pus within the external oblique aponeurosis, with a fistula tract connected to the ileum. After abdominal exploration, the inflammation was observed to be limited to the ileum and cecum with no other abnormality noted. Ileocecectomy was done with side-to-side anastomosis between the ileum and ascending colon. The resected part was sent for histopathology, which confirmed the characteristics of Crohn’s disease. Conclusions: The diagnosis of Crohn’s disease remains challenging. Its management is multi-disciplinary. Surgical management is dependent on disease location and severity. It seems that early surgery is gradually going to play a more important role in the multidisciplinary management of Crohn’s disease, rather than being a last-resort therapy. Key Words: Crohn’s disease, Diagnosis, Surgical management, Case Report.

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Intracranial Tuberculomas in a Nonimmuncompromised Patient with Abdominal Tuberculosis Misdiagnosed as Crohn’s Disease

Cited by 4 publications

References 14 publications

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Misdiagnosis and Mistherapy of Crohn's Disease as Intestinal Tuberculosis

Multiple tuberculomas in an immunocompetent patient and their diagnostic challenge in a high prevalence country: Case report and literature review

A Patient with Crohn’s Disease Presenting with a Picture Mimicking a Strangulated Incisional Hernia: A Case Report

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