Presentation
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]
Clinical presentation The clinical presentation was acute peritonism in seven patients, and pneumoperitoneum with features of peritonitis in five patients. Frequency of clinical presentation is presented in [Table 1]. [afrjpaedsurg.org]
Entire Body System
- 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]
Tiredness, weight loss and lack of appetite are the early symptoms of the infection and can precede bowel symptoms by several months. [doctor.ndtv.com]
- 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]
Gastrointestinal
- 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]
She is still on some TB drugs but is now experiencing minimal abdominal pain. “I am thankful to Dr Alok and his team at Paras Gurgaon to ensure that I get back on my feet and become able to lead a pain free life. [parashospitals.com]
A 30-year-old man was admitted with a three-day history of abdominal pain who had emergency surgery for multiple perforations of the distal ileum. [jscr.oxfordjournals.org]
- 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]
Definition / general Disease occasionally seen in less developed countries Small intestinal disease may be transmitted via contaminated milk Symptoms: abdominal pain, malabsorption, strictures, perforation, fistula Sites Terminal ileum, cecum, appendix [pathologyoutlines.com]
Definition: —A condition of sub-acute or chronic disease of the walls of the intestines, in which there is the characteristic deposit of tubercle, with the constitutional evidences. [henriettes-herb.com]
- Abdominal Tenderness
Malabsorption Fistula Bowel obstruction Fatigue Diffuse abdominal tenderness Night sweats Abdominal tb diagnosis Blood tests: These help in detecting elevated levels of transaminases, ESR and detects anemia. [thegastrosurgeon.com]
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]
[…] pain (80-95%) - Fever (40-70%) - Weight loss (40-90%) - Diarrhea (11-20%) - Constipation - Abdominal Distension - Fatigue - Diffuse abdominal tenderness - Night sweats - Malabsorption - Fistula - Strictures - Bowel Obstruction Findings and Pathology [crohnsforum.com]
Workup
MATERIALS AND METHODS: From January 2006 to August 2011, a total of 81 consecutive patients (64 patients with CD and 17 patients with ITB) who received CTE on the initial workup were included. [ncbi.nlm.nih.gov]
Skin Test
- 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]
Other Pathologies
- 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]
Treatment
Histology confirmed intestinal tuberculosis and she made full recover with 6 months of anti-tuberculosis treatment. [ncbi.nlm.nih.gov]
Both started anti-TB treatment. [elsevier.pt]
Treatment is with antitubercular drugs and/or surgery. Antitubercular drugs are given for at least six months initially; depending upon the results of response to therapy, treatment is continued further (12- 18 months). [medindia.net]
Prognosis
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]
PROGNOSIS The prognosis of uncomplicated abdominal tuberculosis is good. Most patients who undergo effective surgical management of complications respond well. [ots1.narod.ru]
Abstract Favorites PDF Get Content & Permissions Open Expression of Prostate-Specific Membrane Antigen in Tumor-Associated Vasculature Predicts Poor Prognosis in Hepatocellular Carcinoma Jiao, Dian; Li, Yu; Yang, Fa; More Clinical and Translational Gastroenterology [nature.com]
[…] 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]
Etiology
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]
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]
HIV coexistence has dramatically changed the etiological agents & the pattern of presentation of abdominal tuberculosis thus producing diagnostic difficulties 5. [slideshare.net]
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]
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]
Epidemiology
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]
Pathophysiology
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]
[…] 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]
[…] right 1/3 rd to ½ of transverse colon; the incidence of post-operative diarrhoea is considerably diminished. [5] An increased awareness of intestinal tuberculosis coupled with varied clinical presentations, nonspecific signs and symptoms, knowledge of pathophysiology [dx.doi.org]
Prevention
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]
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]
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]
Abdominal TB is generally responsive to medical treatment alone, so early diagnosis can prevent unnecessary surgical intervention [1]. [sonoworld.com]
Further studies are needed to increase our confidence as to whether six-month regimens are as good as nine-month regimens for preventing relapse ; and to provide information about treating abdominal TB in children and in people with HIV. [cochrane.org]