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]

The most common presenting complaint is abdominal pain. Fever, diarrhea, and anorexia may also be present. [journals.lww.com]

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]

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]

• 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]

  Clinical features include ABDOMINAL PAIN; FEVER; and palpable mass in the ileocecal area. [fpnotebook.com]

  Fever and weight loss are prominent symptoms of ileocecal abscess. Non-Hodgkin lymphoma presented with fever, vomiting and loss of weight. [ispub.com]

  Her problems persisted and she developed malnutrition, hypoalbuminemia, and intermittent fever and was started on treatment for tuberculosis. She did not improve and developed perianal disease. [journals.lww.com]

• 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]

  • 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]

  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]

  Patients infected with Mycobacterium Tuberculosis(Mtb) may present with ileocecal infection, weight loss and bleeding per rectum. [journals.lww.com]

• Anemia

  Dameshek, W.: “Target Cell” Anemia: Anerythroblastic Type of Cooley’s Erythroblastic Anemia, Am. Jour. Med. Sei., 200, 495, 1940. Google Scholar 8. Strauss, M. D., Daland, G. A., and Fox, H. J.: Familial Microcytic Anemia, Am. Jour. Med. [link.springer.com]

  Exam: AIIMS Pre PG Nov 2009 General Medicine [Change] [Follow This] < Create Another Question >> [Edit] Ileocecal tuberculosis is associated with – [Edit] 100.0% Megaloblastic anemia [Edit] 0.0% Iron deficiency anemia [Edit] 0.0% Sideroblastic anemia [quespedia.com]

  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]

  Symptoms such as abdominal pain, weight loss, fever, loss of appetite, diarrhea or constipation, fatigue, overall deterioration of the general condition, and anemia may be observed. [pubs.sciepub.com]

• Asymptomatic

  The true incidence of intestinal TB is unknown, as it can be asymptomatic, and by its nature, often diverts its diagnosis to neoplastic diseases or inflammatory bowel disease. [pesquisa.bvsalud.org]

  References: [7] [8] [9] Pathophysiology Clinical features Latent infection Asymptomatic The patient is not contagious. [amboss.com]

  Since he has remained usually asymptomatic and his viral load has been set < 20 copies/mL on average, the low CD4 count has not been considered an extremely alarming event. [omicsonline.org]

  Yao Colonoscopy in the diagnosis of intestinal tuberculosis in asymptomatic patients Gastrointest Endosc., 59 (2004), pp. 362-368 [3] H.T. Gan, Y.Q. Chen, Q. [elsevier.es]

  Primary infection is usually asymptomatic. The presentation of secondary infection is variable and often nonspecific. A high index of suspicion in patients from particular risk groups is essential to make a diagnosis. [patient.info]

• Infertility

  In the male, tuberculosis involves prostate and epididymis most often with non-tender induration and infertility. [library.med.utah.edu]

  There may be kidney lesions, salpingitis, abscesses and infertility in females and swelling of the epididymis in males. [patient.info]

• Abdominal Pain

  The most common presenting complaint is abdominal pain. Fever, diarrhea, and anorexia may also be present. [journals.lww.com]

  Clinical features include ABDOMINAL PAIN; FEVER; and palpable mass in the ileocecal area. [fpnotebook.com]

  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]

  Her RUQ pain radiated to her back and worsened after meals, while her lower abdominal pain had no clear triggers. [cureus.com]

• Diarrhea

  R19.7 ICD-10-CM Diagnosis Code R19.7 Diarrhea, unspecified 2016 2017 2018 2019 Billable/Specific Code Applicable To Diarrhea NOS Type 1 Excludes functional diarrhea ( K59.1 ) neonatal diarrhea ( P78.3 ) psychogenic diarrhea ( F45.8 ) tuberculous A18.32 [icd10data.com]

  Case Report: Ileocecal Tuberculosis Abstract A 25 year-old female recent immigrant from Southeast Asia is admitted to hospital with chronic cough and fever with a new onset of bloody diarrhea. [ojs.library.ubc.ca]

  We present the case of a patient with chronic diarrhea, consumptive syndrome and without respiratory symptoms at its onset. Biblioteca responsável: CL1.1 [pesquisa.bvsalud.org]

  Mucosa predominant disorder is associated with mucosal injury and presents with malabsorption, diarrhea, and protein-losing enteropathy. [ijhas.in]

• 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]

• Hematochezia

  Hematochezia represents rectal bleeding and can be a sign of an intestinal inflammatory bowel disease. [ncbi.nlm.nih.gov]

  Diarrhea, hematochezia, and extraintestinal manifestations are more common in patients with Crohn’s disease. [blogs.nejm.org]

  The main symptom of lower GI bleeding is blood exiting the anus, either alone (bright red blood per rectum) or as red-stained stool (hematochezia). Stool that is tarry and dark (melena) typically points to upper GI bleeding. [gastrointestinalatlas.com]

• Blood in Stool

  As her blood and stool studies were finalized as negative on hospital day 3, the antibiotics were stopped. [cureus.com]

  Dutta et al. followed up 30 patients of ITB and 30 patients of CD and reported that patients with CD had longer duration of symptoms ( P < 0.001), blood mixed stool ( P = 0.006), longitudinal ulcers ( P = 0.005), skip lesions ( P = 0.008), and involvement [jdeonline.in]

• Jaundice

  A tuberculous periportal lymph node can cause obstructive jaundice by compressing the bile duct. The patient usually presents with hepatomegaly, with or without jaundice. [ots1.narod.ru]

• Ulcer

  Ulcerative type and hyperplastic type. Q 4. What are the differences between ulcerative type and hyperplastic type? No Ulcerative Hyperplastic 1. Secondary to pulmonary tuberculosis Primary 2. [7med-pdf.com]

  Ascending colon 6 (85.7) 6 (66.7) 6 (66.7) NS Shape of lesion Geographic ulcer 3 (42.9) 2 (22.2) 2 (22.2) NS Irregular ulcer 1 (14.3) 3 (33.3) 5 (55.6) NS Aphthous ulcer 0 (0) 2 (22.2) 6 (66.7) 0.01 Transverse ulcer 3 (42.6) 2 (22.2) 2 (22.2) NS Stenosis [wjgnet.com]

  Aphthoid ulcers or frank ulceration can be seen as well. Acid-fast stains may demonstrate the microorganisms, but culture or PCR assays may also be helpful. [medunigraz.at]

  The colonoscopy showed an ileal ulcer 5 cm from the ileocecal valve. The ulcer was biopsied, and histology showed epithelial granulomas with one acid-fast bacillus. The cultures were negative for acid-fast bacilli. [journals.lww.com]

  In a study by Lee et al ., [3] anorectal lesions, longitudinal ulcers, aphthous ulcers, and cobblestone appearance were found to be significantly more common in patients with Crohn's disease than TB. [jmedtropics.org]

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]

• 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]

• Hypoalbuminemia

  Her problems persisted and she developed malnutrition, hypoalbuminemia, and intermittent fever and was started on treatment for tuberculosis. She did not improve and developed perianal disease. [journals.lww.com]

  Hematologic findings are nonspecific and include raised erythrocyte sedimentation rate, anemia and hypoalbuminemia. [ncbi.nlm.nih.gov]

• 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]

[…] of anti-tuberculosis treatment (P = 0.01, Table 3). [wjgnet.com]

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]

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]

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]

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]

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]

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 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]

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]

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]

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]

[…] 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 ICD coding ICD-10: A18.32 - tuberculous enteritis Epidemiology [pathologyoutlines.com]

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]

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]