Here we present a case of intestinal tuberculosis which initially diagnosed as Crohn's disease but after starting immunosuppressive agents he presented with disseminated tuberculosis. [ncbi.nlm.nih.gov]

• Fever

  Weight loss was seen in 40 (66.7%) patients, fever 36 (60%), night sweats 30 (50%), anorexia in 30 (50%) and pulmonary tuberculosis in 18 (30%) patients. [ncbi.nlm.nih.gov]

• Weight Loss

  It also aims to raise awareness that chronic diarrhoea and weight loss are common symptoms of colonic tuberculosis. [ncbi.nlm.nih.gov]

• Pathologist

  Differential diagnosis of Crohn s disease and intestinal tuberculosis poses a dilemma to clinicians and pathologists as both are chronic granulomatous disorders with similar clinical features. [ncbi.nlm.nih.gov]

  However, in the absence of caseating granulomas, it becomes difficult for the pathologist to differentiate it from other inflammatory and granulomatous lesions.[ 6, 7 ] Newer diagnostic modalities such as TB PCR have now been established for the diagnosis [tropicalgastro.com]

  Radiological findings are unspecific and the pre-operative diagnosis, based on the biopsies obtained from colonoscopy, is only achieved in case of innumerous biopsies repeatedly collected at the same site, thus providing the pathologist with better specimens [scielo.br]

• Malaise

  The CD patients more frequently reported malaise (87% vs 64%, P 0.03), nausea (84% vs 56%, P 0.01), pain in the right lower abdominal quadrant on examination (90% vs 54%, P 0.01) and urban domicile (65% vs 42%, P 0.05). [ncbi.nlm.nih.gov]

  Symptoms Constitutional localsymptoms depending upon site involved  Constitutional symptoms are: • Fever • Malaise • Anemia • Night sweats • Loss of weight • Pain abdomen: colicky if luminal compromise, dull and continuous when mesenteric lymph nodes [slideshare.net]

  The symptoms of chronic abdominal tuberculosis are insidious, and include fever, which may be present in two-thirds of patients, night sweats, malaise, weakness, anorexia, and weight loss. Abdominal pain is often vague and dull. [ots1.narod.ru]

• Whipple Disease

  MAC infection is also called pseudo-Whipple disease because of the diffuse mucosal fold thickening in the jejunum and histiocytic aggregates infected with MAC that stain positive with periodic acid–Schiff testing. [emedicine.medscape.com]

• Abdominal Pain

  Majority of patients (46, 76.7%) had abdominal pain, 26 (43.3%) had vomiting; abdominal distension was seen in 22 (36.7%) cases, diarrhoea and constipation in 16 patients (26.7%) and abdominal mass in 14 patients (23.3%). [ncbi.nlm.nih.gov]

• Diarrhea

  The diarrhea resolved after 4 wk of antituberculous therapy. Repeat perfusion studies after 3 mo showed normal absorption in the ileum. This case report suggests that intestinal tuberculosis can cause secretory diarrhea. [ncbi.nlm.nih.gov]

• Constipation

  The common symptoms were chronic right lower abdominal and periumbilical pain (87.7%), weight loss (80.2%), anemia (64.2%), diarrhea (46.9%), fever (43.2%), diarrhea alternating with constipation (38.3%), and night sweats (30.9%). [ncbi.nlm.nih.gov]

  Common symptoms of abdominal tuberculosis are: Fever Loss of appetite Fatigue Weight loss Constipation Diarrhea Colicky pain in the abdomen Abdominal Swelling and tenderness Night sweats Diagnosis & Treatment of Abdominal Tuberculosis Diagnosis of abdominal [medindia.net]

• Intestinal Disease

  This case points out the need for awareness of intestinal tuberculosis in the differential diagnosis of chronic intestinal disease. [ncbi.nlm.nih.gov]

  The intestinal disease showed itself perhaps eighteen months before death, with no evidence of previous infection elsewhere. The evidences of impaired nutrition with emaciation are first seen. [henriettes-herb.com]

• Abdominal Tenderness

  Diagnosis Back to Top Mild right lower abdominal tenderness X-Rays may show colon irregularities Colonoscopy with biopsy may prove the diagnosis Pathogenesis/Pathophysiology Back to Top Pathogen and routes of spread Routes of GI infection include the [nursing-resource.com]

  […] both commonly causing lesions in the ileum and ileocecal region. [2] Symptoms of Intestinal Tuberculosis - Abdominal pain (80-95%) - Fever (40-70%) - Weight loss (40-90%) - Diarrhea (11-20%) - Constipation - Abdominal Distension - Fatigue - Diffuse abdominal [crohnsforum.com]

  tenderness Night sweats Abdominal tb diagnosis Blood tests: These help in detecting elevated levels of transaminases, ESR and detects anemia. [thegastrosurgeon.com]

• Aphthous Ulceration

  Endoscopy findings such as longitudinal ulcer, aphthous ulcer, and cobblestone appearance were only seen in CD cases (34.6%, 21.2%, and 23.1%, respectively). Granulomas were detected in the majority of cases with longitudinal ulcers (88.9%). [ncbi.nlm.nih.gov]

  In some cases, aphthous ulcers may be seen in the colon. Caseation may not always be seen in the granuloma, especially in the mucosa, but it is almost always seen in the regional lymph nodes. [nursing-resource.com]

  The earliest and most characteristic endoscopic finding in CD is the aphthous ulcer. [46], [47] It can be found throughout the GIT. [jdeonline.in]

• Oral Ulcers

  RESULTS: On univariate analysis, the features of hematochezia, intestinal obstruction, fistula, oral ulcers, longitudinal ulcers, cobblestone appearance and pseudopolyps were more common in Crohn's disease than in intestinal tuberculosis (p 0.05). [ncbi.nlm.nih.gov]

  Extraintestinal manifestations were present in 4 patients – 3 had arthralgia, 1 had pyoderma gangrenosum and 3 had oral ulcers. [tropicalgastro.com]

His workup showed stricture in ascending colon, multiple liver abscesses with pneumobilia on CT scan. Upper GI endoscopy revealed stricture in 2nd part of duodenum distally. [ncbi.nlm.nih.gov]

• Skin Test Positive

  The features of night sweats, concomitant pulmonary tuberculosis, positive tuberculin skin test, positive antibody to tuberculosis, abdominal lymphadenopathy, ascites, transverse ulcers, patulous ileocecal valve, and granulomas were more common in intestinal [ncbi.nlm.nih.gov]

• Granulomatous Tissue

  Microscopic Changes - Exuberant granulomatous tissue extending onto the serosa - Esenteric fat, enlarged lymph nodes, fibrosis, and hypertrophy of the muscularis. - Granulomas in the mucosa or the Peyer's patches. [crohnsforum.com]

Histology confirmed intestinal tuberculosis and she made full recover with 6 months of anti-tuberculosis treatment. [ncbi.nlm.nih.gov]

Prognosis: —If nutrition can be sustained, these patients may live a number of years, and there is no doubt that a number of pronounced cases have recovered. [henriettes-herb.com]

Mitchel RS: The prognosis of bilateral symmetrical diffuse nodular pulmonary tuberculosis and its possible relation to intestinal tuberculosis. Dis Chest 1956, 29 :669–674. Google Scholar 22. [link.springer.com]

The possible reason for the second patient's adverse prognosis may be due to the fact that he presented advanced alcoholic hepatopathy. [scielo.br]

Nevertheless, ITB perforation has a poor prognosis, with mortality greater than 30% (Lee et al. 2012 ). [springerplus.springeropen.com]

Fulminant amebic colitis occurring together with intestinal tuberculosis is an uncommon event and may present an interesting patho-etiological relationship. The diagnosis was proven by histopathologic examination of resected specimen. [ncbi.nlm.nih.gov]

He had history of an episode of pancreatitis of unknown etiology 3 years prior to this hospitalization, allergy to ceftriaxone, and a right orchiectomy for non-specified reason. [elsevier.es]

We aimed to study the various clinical presentations leading to intestinal resection, with identification of different etiological factors by histopathological examination; and to illustrate, discuss and describe the various histopathological features [dx.doi.org]

Clinical presentation of ITB, the true etiology, may be initially masked by the effect of immunosuppressants used for CD, just like our case. [springerplus.springeropen.com]

In this article, we examine the changing trends in the epidemiology of CD and ITB, in addition to clinical features that aid in the differentiation of both diseases. [ncbi.nlm.nih.gov]

Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology. 2004;126(6):1504-17. Linares de la Cal JA, Cantón C, Hermida C, Pérez-Miranda M, Maté-Jiménez J. [revistagastrocol.com]

Epidemiology and outcome of Crohn's disease in a teaching hospital in Riyadh. World J Gastroenterol 2004; 10 :1341–1344. 11. El Mouzan MI, Abdullah AM, Al Habbal MT. Epidemiology of juvenile-onset inflammatory bowel disease in central Saudi Arabia. [nature.com]

Epidemiological study of abdominal tuberculosis among Indian migrants and the indigenous population of Leicester, 1972-1989. Gut 1992; 33:1085-8. 7. Bernardo J. Epidemiology and pathology of extrapulmonary and miliary tuberculosis, 2014. [najms.org]

Clinical appearance of intestinal tuberculosis, short bowel syndrome and of cobalamin and folate deficiency as well as pathophysiology, diagnosis and treatment of these uncommon or even rare diseases are discussed in this case report.Key words: intestinal [ncbi.nlm.nih.gov]

Contents Signs and Symptoms Causative Agent Mode of Transmission Diagnosis Pathogenesis/Pathophysiology Prevention Treatment Complications References Signs and Symptoms Back to Top May have none Fever Anorexia Nausea Flatulence (“gas”) Food intolerance [nursing-resource.com]

Key words: Tuberculosis, Abdominal tuberculosis Advertisement Journal of Molecular Pathophysiology SUBMIT YOUR ARTICLE NOW [scopemed.org]

Radiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy (3) Department of Neonatology and Pediatrics, University of Palermo, Di Cristina Hospital, Palermo, Italy (4) Pediatric Highly Intensive Care Unit, Department of Pathophysiology [bmcresnotes.biomedcentral.com]

[…] 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]

Prevention Back to Top Pasteurizing of milk may help prevent infection. See TB Prevention for more information. Treatment Back to Top Anti-Tuberculosis medications in four drug combination. [nursing-resource.com]

Srictureplasty will relieve the mechanical bowel narrowing and thus prevent the possibility of obstruction. You should wait for having a family till after her treatment. [doctor.ndtv.com]

Also avoid tea, coffee, cold-drinks, alcohols etc. to prevent diarrhea. Surgery : 70% of the patients gets relief by medication. In remaining 30%, dead bacteria’s stays in intestine thus leads to interruption. [medicinalplantsanduses.com]

Therefore, ITB should be always kept in mind in this situation and survey, such as culture or PCR for mycobacterial DNA, should be considered in TB endemic areas to prevent further depressing scenario. [springerplus.springeropen.com]