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Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report

S. Ahmed, Wael Hafez, Jamil El Chayeb, Naimah Al Jassem, A. Massoud, S. Nader, Reham Aboushady

Radiology Case Reports, 2023

13 citations

Abstract

Intestinal Tuberculosis (TB) is a very rare presentation of TB, presenting with a nonspecific symptom that mimics Crohn's disease, making diagnosis challenging. We present a case of intestinal tuberculosis in a 37-year-old female who had long-term abdominal pain and diarrhea and showed all the signs of inflammatory bowel disease (IBD) during a thorough clinical, endoscopic, radiologic, and histologic examination. Seven months of right mid- and lower-abdominal discomfort brought a 37-year-old woman to our hospital with pain, diarrhea, bloating, and tiredness worsening after meals. A CT scan of the abdomen highly suggested inflammatory bowel disease. A colonoscopy revealed a patulous ileocecal valve with terminal ileum ulcerations, ileal stenosis, cecum, and valve ulcers, where biopsies findings suggesting also IBD. While planned to start mesalazine; PCR TB testing of biopsy material confirmed tuberculosis. She recovered well following conventional intestinal TB therapy. Intestinal TB is called the great mimicker because its symptoms resemble different illnesses. Misdiagnosis can lead to incorrect treatment, life-threatening complications, and mortality. This paper's radiology, macroscopy, and histopathology highly suggested Crohn's disease, however, intestinal TB was the diagnosis. TB quadrable treatment significantly benefited patients. Consider intestinal TB in this scenario, especially in patients coming from endemic TB areas is highly recommended. The importance of our…

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