Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis
Differentiating Crohn’s disease (CD) from intestinal tuberculosis (TB) is a challenge. In patients suspected of having CD or intestinal TB compounded with active pulmonary TB in its early stages, clinicians often lean towards a diagnosis of intestinal TB. A 14-year-old female patient was admitted wi...
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| Format: | Article |
| Language: | English |
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Jin Publishing & Printing Co.
2021-01-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.kjg.or.kr/journal/view.html?uid=5663&vmd=Full |
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| author | Sumin Park Taeyeong Lee Won Lim Sangkyu Park Hojun Park Jeonghui Yun Dohyeong Kim Sooryong Choi Heetaek Oh Chulsoo Song |
| author_facet | Sumin Park Taeyeong Lee Won Lim Sangkyu Park Hojun Park Jeonghui Yun Dohyeong Kim Sooryong Choi Heetaek Oh Chulsoo Song |
| author_sort | Sumin Park |
| collection | DOAJ |
| description | Differentiating Crohn’s disease (CD) from intestinal tuberculosis (TB) is a challenge. In patients suspected of having CD or intestinal TB compounded with active pulmonary TB in its early stages, clinicians often lean towards a diagnosis of intestinal TB. A 14-year-old female patient was admitted with symptoms of abdominal pain and diarrhea with hematochezia. Colonoscopy revealed a stricture of the ileocecal valve and scattered longitudinal ulcers. Initial chest radiography showed consolidation in the left lower lobe of the lung. Chest CT revealed branching nodular opacities and consolidation. The TB PCR of the bronchial washing fluid was positive. The patient was diagnosed with pulmonary and intestinal TB. The colonoscopy findings favored CD. Despite this, anti-tubercular therapy was initiated based on the radiology findings and PCR test. After treatment with anti-tubercular therapy, the patient’s diarrhea and abdominal pain worsened despite the improvement observed on her chest radiography. Follow-up colonoscopy revealed aggravation of her ulcers. The patient was diagnosed with CD and treated with prednisolone and mesalazine. Her clinical condition improved, and follow-up colonoscopy showed significant improvement of the ulcers. This case highlights the need for caution in diagnosis and suggests that clinicians consider reevaluation in similar cases. |
| first_indexed | 2024-12-24T05:14:05Z |
| format | Article |
| id | doaj.art-7a8b9400083b40f3ada936a3ca6da366 |
| institution | Directory Open Access Journal |
| issn | 1598-9992 2233-6869 |
| language | English |
| last_indexed | 2024-12-24T05:14:05Z |
| publishDate | 2021-01-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-7a8b9400083b40f3ada936a3ca6da3662022-12-21T17:13:36ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692021-01-01771303410.4166/kjg.2020.130Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary TuberculosisSumin Park0Taeyeong Lee1Won Lim2Sangkyu Park3Hojun Park4Jeonghui Yun5Dohyeong Kim6Sooryong Choi7Heetaek Oh8Chulsoo Song9https://orcid.org/0000-0002-0955-6246Department of Internal Medicine, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaComprehensive Medical Examination Center, Good Samsun Hospital, Busan, KoreaComprehensive Medical Examination Center, Good Samsun Hospital, Busan, KoreaComprehensive Medical Examination Center, Good Samsun Hospital, Busan, KoreaDepartment of Internal Medicine, Good Samsun Hospital, Busan, KoreaDifferentiating Crohn’s disease (CD) from intestinal tuberculosis (TB) is a challenge. In patients suspected of having CD or intestinal TB compounded with active pulmonary TB in its early stages, clinicians often lean towards a diagnosis of intestinal TB. A 14-year-old female patient was admitted with symptoms of abdominal pain and diarrhea with hematochezia. Colonoscopy revealed a stricture of the ileocecal valve and scattered longitudinal ulcers. Initial chest radiography showed consolidation in the left lower lobe of the lung. Chest CT revealed branching nodular opacities and consolidation. The TB PCR of the bronchial washing fluid was positive. The patient was diagnosed with pulmonary and intestinal TB. The colonoscopy findings favored CD. Despite this, anti-tubercular therapy was initiated based on the radiology findings and PCR test. After treatment with anti-tubercular therapy, the patient’s diarrhea and abdominal pain worsened despite the improvement observed on her chest radiography. Follow-up colonoscopy revealed aggravation of her ulcers. The patient was diagnosed with CD and treated with prednisolone and mesalazine. Her clinical condition improved, and follow-up colonoscopy showed significant improvement of the ulcers. This case highlights the need for caution in diagnosis and suggests that clinicians consider reevaluation in similar cases.http://www.kjg.or.kr/journal/view.html?uid=5663&vmd=Fullcrohn diseasetuberculosisgastrointestinaltuberculosis;pulmonary |
| spellingShingle | Sumin Park Taeyeong Lee Won Lim Sangkyu Park Hojun Park Jeonghui Yun Dohyeong Kim Sooryong Choi Heetaek Oh Chulsoo Song Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis The Korean Journal of Gastroenterology crohn disease tuberculosis gastrointestinal tuberculosis; pulmonary |
| title | Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis |
| title_full | Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis |
| title_fullStr | Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis |
| title_full_unstemmed | Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis |
| title_short | Case of Crohn’s Disease Initially Misdiagnosed as Intestinal Tuberculosis Due to Active Pulmonary Tuberculosis |
| title_sort | case of crohn s disease initially misdiagnosed as intestinal tuberculosis due to active pulmonary tuberculosis |
| topic | crohn disease tuberculosis gastrointestinal tuberculosis; pulmonary |
| url | http://www.kjg.or.kr/journal/view.html?uid=5663&vmd=Full |
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