FIGURE 2 - uploaded by Adam Kurnick
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Left: Wall thickening of the distal ileum (circle). Right: Dilation of proximal bowel loops (double-headed arrow).
Source publication
Intestinal tuberculosis (TB) may mimic Crohn’s disease (CD) and may be overlooked where TB is not endemic. We present a case of an elderly patient with partial small bowel obstruction caused by intestinal TB, initially suspected to have ileal stricturing CD. In our case, the patient had multiple hospitalizations due to small bowel obstruction. She...
Contexts in source publication
Context 1
... X-ray was unremarkable and abdominal Xray revealed distension of the loops and a few air-fluid levels with nonspecific dispersion ( Figure 1). CT scans revealed increased wall thickness of the distal ileum and dilation of the proximal bowel loops, with oral contrast reaching the rectum ( Figure 2). Esophagogastroduodenoscopy was unremarkable and the ileo-colonoscopy showed no significant endoscopic or histologic changes although the involved ileum was not reached. ...
Context 2
... X-ray was unremarkable and abdominal X-ray revealed distension of the loops and a few airfluid levels with nonspecific dispersion (Figure 1). CT scans revealed increased wall thickness of the distal ileum and dilation of the proximal bowel loops, with oral contrast reaching the rectum (Figure 2). Esophagogastroduodenoscopy was unremarkable and the ileo-colonoscopy showed no significant endoscopic or histologic changes although the involved ileum was not reached. ...
Citations
... In 2021, the World Health Organization recorded 10.6 million cases of TB worldwide causing 1.6 million deaths. 1 Latent tuberculosis infection (LTBI) (which occurs in persons infected with M. tuberculosis but without symptoms) is estimated to infect around 25% of the global population. 2 While LTBI is not immediately problematic, the carrier being relatively healthy and unable to infect others, 3 it can be activated if bacterial growth outruns the ability of the host's immune system to control the pathogen. This can occur when the host develops an immunodeficiency disorder (Graves disease, 4 Hashimoto thyroiditis, 5 rheumatoid arthritis, 6 Crohn disease) 7 or is infected with HIV. Studies have reported that a concurrent HIV infection in LTBI patients results in 30% of individuals developing active tuberculosis, as opposed to 5%-10% in HIV-negative patients. ...
This paper describes the design and optimization of a 10 ml cartridge for patient sample processing using a 3.5 GHz (empty resonant frequency) TM010 cylindrical microwave cavity. The cartridge has been designed to augment a novel approach for the rapid diagnosis of M. tuberculosis (the causative agent of Ttuberculosis), which uses the direct application of microwaves to a bacteria-containing sample to release pathogen-specific DNA. The target bacterial DNA is then captured and recovered using magnetic nanoparticles coated with pathogen-specific DNA probes. Excitation parameters were optimized using three surrogates for M. tuberculosis, namely, M. smegmatis, M. abscessus, and M. bovis suspended in water and simulated sputum. The paper also explores the mechanism of microwave-mediated DNA release from bacteria using scanning electron microscopy. Examination of bacteria exposed to microwaves at power levels known to mediate the release of DNA reveals no obvious signs of permanent cell disruption, suggesting that a more subtle interaction is taking place. Finally, the presence of microwave-liberated M. bovis DNA was able to be detected at a level of sensitivity comparable to that achieved using microscopy.
... Both may present similar clinical, radiological and endoscopic findings, so the differential diagnosis may be challenging for the clinician (1). However, gastrointestinal tuberculosis can also mimic other abdominal diseases such as tumors, ischemic colitis, periappendicular abscesses or other intestinal infections (2)(3)(4)(5). Therefore, clinical suspicion and the consideration of epidemiological risk factors are essential for a differential diagnosis. ...
A 52-year-old Senegalese male presented due to abdominal pain and fever, with findings suggestive of a stenosing tumor of the right colon. Biopsies during colonoscopy were compatible with adenocarcinoma and infiltration into neighboring organs was observed during the surgery. New biopsies were taken that did not show dysplasia but granulomatous foci that were suggestive of a non-filiated infection. Thus, tuberculosis was ruled out.
Este artigo tem por objetivo conscientizar sobre a dificuldade da diferenciação entre a Doença de Crohn e a Tuberculose, bem como os impactos desse impasse no cotidiano clínico. Trata-se de uma revisão integrativa baseada em banco de dados online que forneceram artigos gratuitos, datados entre 2019 e 2023, em língua portuguesa, espanhola e inglesa que correspondiam ao tema delimitado. Conclui-se que embora as dificuldades na consolidação de protocolos, o estudo histológico tem sido a aposta para a otimização diagnóstica, bem como as políticas para erradicação da TB tem impactado no prognóstico dos enfermos. Palavras-chave: Doença de Crohn, Tuberculose Gastrointestinal, Diagnóstico.
Crohn's disease is a chronic inflammatory disease that can affect any portion of the gastrointestinal tract. Associated symptoms can vary based on the severity of disease, extent of involvement, presence of extraintestinal manifestations, and development of complications. Diagnosis is based on a constellation of findings. Many diseases can mimic Crohn's disease and lead to diagnostic conundrums. These include entities associated with the gastrointestinal luminal tract, vascular disease, autoimmune processes, various infections, malignancies and complications, drug- or treatment-induced conditions, and genetic diseases. Careful consideration of possible causes is necessary to establish the correct diagnosis.
Background and Aim: Crohn's disease is a chronic idiopathic disease in the category of gastrointestinal tract inflammation without any obvious reason. Clinical signs include abdominal pain, and diarrhea, which may be accompanied by a fistula or intestinal obstruction. Differential diagnosis of Crohn’s disease and intestinal tuberculosis is a complex and difficult challenge.
Case presentation: The patient was a 70-year-old woman who had been hospitalized due to fistulas with 4 years of discharge in the left inguinal and gluteal area. The patient's vital signs were stable, and she did not report any fever, chills, or gastrointestinal symptoms. Diagnostic tuberculosis procedures were performed for this patient and despite the lack of evidence in favor of intestinal tuberculosis, experimental tuberculosis treatment was started for him. Despite 10 months of anti-tuberculosis treatment, the symptoms and fistulas of the patient did not recover in 2016. On spiral computed tomography scan of the lung and mediastinum without injection, the presence of cardiomegaly, evidence of ground-glass was seen along with an increased thickness of the interlobular septa in the middle lobe of the right lung and ground glass opacities at the base of both lungs. Since the patient had typical intestinal tuberculosis symptoms, discharge cultivation and smear were performed and it did not grow on Mycobacterium tuberculosis bacillus acid staining. The patient underwent biopsy with MR Enterography, and Crohn’s diagnosis was confirmed. The patient was treated with Metronidazole, Ciprofloxacin, and a combination of Azathioprine and Infliximab.
Conclusion: According to the rare case reported, advanced diagnostic measures should be taken in dealing with patients with intestinal tuberculosis or Crohn’s disease.
