Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report
Intestinal Tuberculosis (TB) is a very rare presentation of TB, presenting with a nonspecific symptom that mimics Crohn's disease, making diagnosis challenging. We present a case of intestinal tuberculosis in a 37-year-old female who had long-term abdominal pain and diarrhea and showed all the...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043323004764 |
| _version_ | 1797737957651644416 |
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| author | Sabah Ahmed, MBBCh Wael Hafez, MD Jamil El Chayeb, MD Naimah Al Jassem, MD Amr Massoud, MD Simon Nader, MSc Reham Aboushady, MSc |
| author_facet | Sabah Ahmed, MBBCh Wael Hafez, MD Jamil El Chayeb, MD Naimah Al Jassem, MD Amr Massoud, MD Simon Nader, MSc Reham Aboushady, MSc |
| author_sort | Sabah Ahmed, MBBCh |
| collection | DOAJ |
| description | Intestinal Tuberculosis (TB) is a very rare presentation of TB, presenting with a nonspecific symptom that mimics Crohn's disease, making diagnosis challenging. We present a case of intestinal tuberculosis in a 37-year-old female who had long-term abdominal pain and diarrhea and showed all the signs of inflammatory bowel disease (IBD) during a thorough clinical, endoscopic, radiologic, and histologic examination. Seven months of right mid- and lower-abdominal discomfort brought a 37-year-old woman to our hospital with pain, diarrhea, bloating, and tiredness worsening after meals. A CT scan of the abdomen highly suggested inflammatory bowel disease. A colonoscopy revealed a patulous ileocecal valve with terminal ileum ulcerations, ileal stenosis, cecum, and valve ulcers, where biopsies findings suggesting also IBD. While planned to start mesalazine; PCR TB testing of biopsy material confirmed tuberculosis. She recovered well following conventional intestinal TB therapy. Intestinal TB is called the great mimicker because its symptoms resemble different illnesses. Misdiagnosis can lead to incorrect treatment, life-threatening complications, and mortality. This paper's radiology, macroscopy, and histopathology highly suggested Crohn's disease, however, intestinal TB was the diagnosis. TB quadrable treatment significantly benefited patients. Consider intestinal TB in this scenario, especially in patients coming from endemic TB areas is highly recommended. The importance of our case report is increasing the awareness that intestinal TB can mimic inflammatory bowel disease and other disorders such as chronic disease and malignancy, for which the treatment is completely different and could lead to fetal outcome; therefore, we should maintain a high level of suspicion when evaluating patients with nonspecific symptoms, particularly in endemic areas of the disease, to obtain a correct diagnosis and appropriate treatment. |
| first_indexed | 2024-03-12T13:35:59Z |
| format | Article |
| id | doaj.art-0352ddfc13ea48e69b087b55c37de7cf |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-03-12T13:35:59Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-0352ddfc13ea48e69b087b55c37de7cf2023-08-24T04:34:35ZengElsevierRadiology Case Reports1930-04332023-10-01181036803685Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case reportSabah Ahmed, MBBCh0Wael Hafez, MD1Jamil El Chayeb, MD2Naimah Al Jassem, MD3Amr Massoud, MD4Simon Nader, MSc5Reham Aboushady, MSc6NMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesCorresponding author.; NMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesNMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesNMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesNMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesNMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesNMC Royal Hospital, Khalifa City, Abu Dhabi, 764659, United Arab EmiratesIntestinal Tuberculosis (TB) is a very rare presentation of TB, presenting with a nonspecific symptom that mimics Crohn's disease, making diagnosis challenging. We present a case of intestinal tuberculosis in a 37-year-old female who had long-term abdominal pain and diarrhea and showed all the signs of inflammatory bowel disease (IBD) during a thorough clinical, endoscopic, radiologic, and histologic examination. Seven months of right mid- and lower-abdominal discomfort brought a 37-year-old woman to our hospital with pain, diarrhea, bloating, and tiredness worsening after meals. A CT scan of the abdomen highly suggested inflammatory bowel disease. A colonoscopy revealed a patulous ileocecal valve with terminal ileum ulcerations, ileal stenosis, cecum, and valve ulcers, where biopsies findings suggesting also IBD. While planned to start mesalazine; PCR TB testing of biopsy material confirmed tuberculosis. She recovered well following conventional intestinal TB therapy. Intestinal TB is called the great mimicker because its symptoms resemble different illnesses. Misdiagnosis can lead to incorrect treatment, life-threatening complications, and mortality. This paper's radiology, macroscopy, and histopathology highly suggested Crohn's disease, however, intestinal TB was the diagnosis. TB quadrable treatment significantly benefited patients. Consider intestinal TB in this scenario, especially in patients coming from endemic TB areas is highly recommended. The importance of our case report is increasing the awareness that intestinal TB can mimic inflammatory bowel disease and other disorders such as chronic disease and malignancy, for which the treatment is completely different and could lead to fetal outcome; therefore, we should maintain a high level of suspicion when evaluating patients with nonspecific symptoms, particularly in endemic areas of the disease, to obtain a correct diagnosis and appropriate treatment.http://www.sciencedirect.com/science/article/pii/S1930043323004764TuberculosisInflammatory bowel disease (IBD)Gastrointestinal ulcers |
| spellingShingle | Sabah Ahmed, MBBCh Wael Hafez, MD Jamil El Chayeb, MD Naimah Al Jassem, MD Amr Massoud, MD Simon Nader, MSc Reham Aboushady, MSc Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report Radiology Case Reports Tuberculosis Inflammatory bowel disease (IBD) Gastrointestinal ulcers |
| title | Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report |
| title_full | Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report |
| title_fullStr | Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report |
| title_full_unstemmed | Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report |
| title_short | Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report |
| title_sort | intestinal tuberculosis and inflammatory bowel disease the usual challenging differential diagnoses a case report |
| topic | Tuberculosis Inflammatory bowel disease (IBD) Gastrointestinal ulcers |
| url | http://www.sciencedirect.com/science/article/pii/S1930043323004764 |
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