Presentation
Case Presentation A 53-year-old Filipino woman with a history of lupus nephritis status post-renal transplantation presented with one month of right upper quadrant (RUQ) pain, lower abdominal pain, and fever. [cureus.com]
The pain, when present, is usually greatest in the right lower abdominal quadrant. On palpation, tenderness about McBurney's point is often found, although the pain may be more generally distributed. A tumefaction is occasionally present. [pubs.rsna.org]
Abstract Intestinal tuberculosis (TB) has a spectrum of clinical presentations. A 7-year-old male child presented with abdominal distension and pain, vomiting, and constipation for a week. [jpss.eu]
There are not much cases of eosinophilic enteritis presenting with intestinal obstruction reported in the literature and hence we are presenting this case report. References 1. Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH. [ijhas.in]
The most common presenting complaint is abdominal pain. Fever, diarrhea, and anorexia may also be present. [journals.lww.com]
Entire Body System
- Fever
However, the persistence of fevers and ileocecal mass on otherwise appropriate antibacterial agents ultimately led to an endoscopic biopsy and a tissue diagnosis. [cureus.com]
Presentation low grade fever associated with loss of appetite and weight loss Patient Data Age: 30 Gender: Female 5 case questions available Loading images... [radiopaedia.org]
Fever and weight loss are prominent symptoms of ileocecal abscess. Non-Hodgkin lymphoma presented with fever, vomiting and loss of weight. [ispub.com]
Typhoid fever: global situation and WHO recommendations. In: Proceedings of the 2nd Asia Pacific Symposium on Typhoid Fever and Other Salmonellosis. Bangkok: Infectious Disease Association of Thailand 1994:39. [appliedradiology.com]
There had been a history of infrequent episodes of pain abdomen and mild fever for more than a month for which he remained under treatment of the medical department of the same hospital. [jpss.eu]
- Weight Loss
Presentation low grade fever associated with loss of appetite and weight loss Patient Data Age: 30 Gender: Female 5 case questions available Loading images... [radiopaedia.org]
Case Report Mr B.S was a 23-year-old man who presented to the clinic on account of recurrent abdominal pain and weight loss of 7 months duration. [jmedtropics.org]
• General symptoms like: weight loss, malaise, evening rise of temperature, etc. • Alternating constipation and diarrhea • Mass in the right iliac fossa • Features of distal small bowel obstruction - abdominal pain, distension and vomiting. Q 3. [7med-pdf.com]
A 72-year-old man presented with 3 months of malaise, diffuse abdominal pain, decreased appetite, and weight loss. On physical examination he was cachectic with bibasilar end-expiratory pleural rubs. [giejournal.org]
Patients infected with Mycobacterium Tuberculosis(Mtb) may present with ileocecal infection, weight loss and bleeding per rectum. [journals.lww.com]
Respiratoric
- Orthopnea
He had history of nonproductive cough, but no drenching night sweat, orthopnea, or paroxysmal nocturnal dyspnea. He was not a known hypertensive, diabetic, or asthmatic. He neither drank alcohol nor smoked cigarette. [jmedtropics.org]
Gastrointestinal
- Abdominal Pain
He had appendectomy about 6 months before presentation at another facility on account of worsening lower abdominal pain without any resolution of the pain. [jmedtropics.org]
A 7-year-old male child presented with abdominal distension and pain, vomiting, and constipation for a week. [jpss.eu]
The most common presenting complaint is abdominal pain. Fever, diarrhea, and anorexia may also be present. [journals.lww.com]
Her RUQ pain radiated to her back and worsened after meals, while her lower abdominal pain had no clear triggers. [cureus.com]
- Chronic Abdominal Pain
[…] tuberculosis is an important differential diagnosis in disease presenting with chronic abdominal pain, fever and malabsorption. [journals.lww.com]
Ileocecal tuberculosis is one of the most important differential diagnoses for chronic abdominal pain in the rural population. [ispub.com]
It has generally nonspecific symptoms, which include chronic abdominal pain, weight loss, diarrhea, nausea, vomiting, and fever. [coloproctol.org]
abdominal pain, chronic diarrhea, weight loss, or growth failure) plus either extraintestinal manifestations (fever, arthritis or arthralgia, pyoderma gangrenosum, perianal disease, or primary sclerosing cholangitis), inflammatory markers (iron deficiency [jdeonline.in]
- Cecal Disease
Key words: Ileal diseases, Cecal diseases, Tuberculosis, gastrointestinal, Ileal neoplasms, Tomography, X-ray computed, Disease attributes, Diagnosis, differential [zgflzz.cn]
- Abdominal Tenderness
Abdominal tenderness with mass in the right iliac fossa was the most common presenting symptom (100%) of TB in this series. [saudijgastro.com]
- Tenderness at McBurney's Point
On palpation, tenderness about McBurney's point is often found, although the pain may be more generally distributed. A tumefaction is occasionally present. [pubs.rsna.org]
Liver, Gall & Pancreas
- Asterixis
There were no focal neurological deficits and asterixis. The full blood count showed a packed cell volume of 25% and white blood cell and platelets count were normal. The chest X-ray was also normal. [jmedtropics.org]
Neurologic
- Focal Neurological Deficit
There were no focal neurological deficits and asterixis. The full blood count showed a packed cell volume of 25% and white blood cell and platelets count were normal. The chest X-ray was also normal. [jmedtropics.org]
- Forgetful
Free Purpose: While gastrointestinal tuberculosis if often thought of as a disease of the developing world, clinicians in the United States should not forget to entertain it as a possibility too. [journals.lww.com]
Workup
Here, we report a case of isolated colonic tuberculosis where the initial diagnostic workup was suggestive of Crohn's disease. [gastrointestinalatlas.com]
Results Of the total study subjects, 266 patients were chosen for diagnostic laparoscopy based on the fact that their findings and symptomatology were so vague that a conclusion could not be drawn from the clinical examination and the usual laboratory workup [intechopen.com]
Endoscopy The most common site of involvement for both ITB and CD diseases is the ileocolonic region, and hence ileocolonoscopy is crucial for the diagnostic workup of both diseases. [ijri.org]
X-Ray
- Colonic Stricture
Ileocaecoplasty and coloplasty are also advocated for ileocaecal and colonic strictures, respectively. [ots1.narod.ru]
Furthermore, the majority of colonic lesions, including strictures, resolve with anti-TB treatment, suggesting that strictures are inflammatory rather than fibrotic. [dovepress.com]
Serum
- Normocytic Anemia
Laboratory studies disclosed normocytic anemia and mild elevation in serum AST and ALT. Chest x-ray films (A) revealed a left upper lobe infiltrate (solid arrow) and right apical pleural reaction (open arrow). [giejournal.org]
Colonoscopy
- Colitis
Our study shows non-caseating granuloma is not significant to the differential diagnosis of tuberculous colitis from Crohn’s colitis. [wjgnet.com]
Differential diagnosis of ileocecal tuberculous colitis includes Crohn’s Disease (CD) and Yersinia infection because these diseases tend to involve ileocecal region and produce granulomatous colitis with strictures, fistulae, tumour-like mass, and aphthoid [medunigraz.at]
DIFFERENTIAL DIAGNOSIS OF INFLAMMATORY BOWEL DISEASE Ulcerative colitis and other causes of enterocolitis The differential diagnosis of UC includes infectious colitis, ischemic colitis, colitis due to drugs, radiation colitis, and solitary rectal ulcer [e-ce.org]
The incidence of each inflammatory bowel disease are; Tbcintestine (65%), Amebic colitis (15.8%), Ulcerative colitis (11.1%) and Crohn's disease (7.1%). 2. [synapse.koreamed.org]
Pleura
- Pleural Rub
On physical examination he was cachectic with bibasilar end-expiratory pleural rubs. Abdominal and digital rectal examinations were unremarkable. Stool was guaiac-negative. [giejournal.org]
Treatment
Duration of treatment is a matter of debate—however evidence suggests that 6 months of anti-tuberculous treatment is as good as 9 months (14-16). [amj.amegroups.com]
[…] of anti-tuberculosis treatment (P = 0.01, Table 3). [wjgnet.com]
Differentiation between ileocecal tuberculosis and eosinophilic enteritis becomes more so important in cases not presenting with complete intestinal obstruction in whom conservative treatment would be planned; as the treatment option is entirely different [ijhas.in]
Most of the guidelines on the treatment of tuberculosis suggest that 6 months treatment is sufficient for extrapulmonary tuberculosis except for bone tuberculosis and tubercular meningitis. [clinicaltrials.gov]
Extensive resection should be avoided in surgical treatment of intestinal tbc. Early diagnosis and treatment will decreas the complications that can be develop during the progress of the disease and consequently the mortality rates. [tjtes.org]
Prognosis
It represents haematogeneous dissemination of uncontrolled tuberculous infection and carries a relatively poor prognosis. It is seen both in primary and post-primary tuberculosis and may be associated with tuberculous infection in others organs. [serau.org]
PROGNOSIS The prognosis of uncomplicated abdominal tuberculosis is good. Most patients who undergo effective surgical management of complications respond well. [ots1.narod.ru]
[…] disease), perforation Obliteration of ileocecal angle with widely patent ileocecal valve Rapid emptying of inflamed terminal ileum (Stierlin sign) Often associated mesenteric lymphadenopathy with increased mesenteric thickness Prognostic factors Worse prognosis [pathologyoutlines.com]
Surgery is the mainstay of treatment and, when done with adequate preparations, has good prognosis. Ileocecal tuberculosis is one of the most important differential diagnoses for chronic abdominal pain in the rural population. [ispub.com]
Etiology
An angiographic appearance demonstrated in two patients is believed to be a useful diagnostic indicator of tuberculous etiology. [ncbi.nlm.nih.gov]
Although 90% of cases of pediatric intussusceptions are idiopathic, a demonstrable etiology is found in 70-90% of adult cases. [1] Adult patients with ileococlic intussusceptions have underlying neoplasm either benign or malignant as an etiological factor [atmph.org]
Certain observations as to the etiology are noted and since the process was reversed by bowel resection, it is assumed that the intestinal tuberculosis was responsible for the so-called target cell anemia. [link.springer.com]
Tuberculosis must be distinguished from other infectious, inflammatory, and neoplastic etiologies. Mortality can reach 20%-30% despite treatment [3]. [cureus.com]
Pathogen host: predominantly humans Mycobacterium bovis : Common pathogen causing gastrointestinal tuberculosis Mechanism of infection: predominantly via ingestion of contaminated cow's milk Pathogen reservoir: predominantly cattle References: [4] [5] Etiology [amboss.com]
Epidemiology
Epidemiology Sex : ♂ > ♀ (2:1) United States Globally The incidence of multidrug-resistant tuberculosis is steadily rising. References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Eosinophilic colitis: Epidemiology, clinical features, and current management. Therap Adv Gastroenterol 2011;4:301-9. 5. Copeland B, Aramide OO, Wehbe SA, Fitzgerald SM, Krishnaswamy G. [ijhas.in]
In: The Epidemiology of Cancer. Ed. G.J. Bourke. Croom Helm, London & Sydney 1983, pp. 162-175. Hakama, M.: Epidemiologi raka molocnoj zelezy v Finljandii. (Epidemiology of breast cancer in Finland.) Vop. Onkol. 1983; 29: 41-46. [stats.cancerregistry.fi]
Global Tuberculosis control - epidemiology, strategy, financing. WHO, 2009, pp 411 (WHO/HTM/TB/2009). Chong VH, Lim KS. Gastrointestinal tuberculosis, review article. Singapore Med J 2009; 50(6):644. Hamer DH, Gorbach SL. [revistas.upb.edu.co]
[…] necessary for multidrug resistant and extensively drug resistant TB Surgery may be necessary in the setting of perforation or obstruction Today, colonic TB is uncommon but in the preantibiotic era, 70% of patients who died developed gastrointestinal TB Epidemiology [pathologyoutlines.com]
Pathophysiology
Pathophysiology, diagnosis and management. 6th ed. Vol 2. Philadelphia: WB Saunders, 1998: 1622-1624. Foster BD, Buchberg B, Parekh NK, Case of intestinal tuberculosis mimicking Crohn’s disease. Am J Case Rep 2012; 13:58-61. Donoghue HD, Holton J. [revistas.upb.edu.co]
[…] gastrointestinal TB have ileocecal disease Also other colorectal sites Multiple sites in 28 - 44% Ileocecum is most common site of abdominal and gastrointestinal TB Isolated colorectal involvement is uncommon - only 10.8% of abdominal gastrointestinal TB Pathophysiology [pathologyoutlines.com]
“Platelets is the definitive current source of state-of-the-art knowledge about platelets and covers the entire field of platelet biology, pathophysiology, and clinical medicine. [blogs.helsinki.fi]
References: [7] [8] [9] Pathophysiology Clinical features Latent infection Asymptomatic The patient is not contagious. [amboss.com]
Prevention
There are also steps you can take to prevent getting OIs: Talk to your health care provider about medicines and vaccines that prevent certain OIs. Prevent exposure to other sexually transmitted diseases. [cdc.gov]
These findings highlight the critical need to improve the prevention, diagnosis and treatment of HIV-associated TB globally. [scienceopen.com]
"Drug-resistant tuberculosis: etiology, management and prevention". Seminars in Respiratory Infections. 9 (2): 104–12. PMID 7973169. ^ Centers for Disease Control and Prevention (CDC) (March 2006). [en.wikipedia.org]
References: [4] [25] [26] [27] [28] [29] Prevention [amboss.com]
Abdominal CT appears to be helpful in making an early diagnosis and preventing the severe complications of intestinal tuberculosis. [ann-clinmicrob.biomedcentral.com]