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1000 Titel
  • Treatment of intestinal tuberculosis with small bowel perforation: a case report
1000 Autor/in
  1. Sasse, Daniel |
  2. Spinner, Christoph D. |
  3. Rothe, Kathrin |
  4. Schneider, Jochen |
  5. Gaa, Jochen |
  6. Würstle, Silvia |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-03-31
1000 Erschienen in
1000 Quellenangabe
  • 15(1):144
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13256-021-02752-2 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011140/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Diagnosis of intestinal tuberculosis poses a dilemma to physicians due to nonspecific symptoms like abdominal pain, fever, nausea, and a change in bowel habit. In particular, the distinction between inflammatory bowel disease and intestinal tuberculosis remains challenging.!##!Case presentation!#!A 27-year-old man from Colombia presented with fever, night sweats, and progressive lower abdominal pain. Computed tomography revealed a thickening of the bowel wall with a mesenterial lymphadenopathy, ascites ,and a pleural tumor mass. Histology of intestinal and pleural biopsy specimens showed a granulomatous inflammation. Although microscopy and polymerase chain reaction (PCR) for Mycobacterium tuberculosis (MTB) were negative, empirical MTB treatment was initiated on suspicion. Due to a massive post-stenotic atrophied intestinal bowel, MTB medications were administered parenterally in the initial phase of treatment to guarantee adequate systemic resorption. The complicated and critical further course included an intra-abdominal abscess and bowel perforation requiring a split stoma, before the patient could be discharged in good condition after 3 months of in-hospital care.!##!Conclusions!#!This case highlights the clinical complexity and diagnostic challenges of intestinal MTB infection. A multidisciplinary team of physicians should be sensitized to a timely diagnosis of this disease, which often mimics inflammation similar to inflammatory bowel disease, other infections, or malignancies. In our case, radiological findings, histological results, and migratory background underpinned the suspected diagnosis and allowed early initiation of tuberculostatic treatment.
1000 Sacherschließung
lokal
lokal Adult [MeSH]
lokal Tuberculosis, Lymph Node [MeSH]
lokal Humans [MeSH]
lokal Intestinal Perforation/etiology [MeSH]
lokal Small bowel perforation
lokal Intestinal Perforation/diagnostic imaging [MeSH]
lokal Colombia [MeSH]
lokal Mycobacterium tuberculosis [MeSH]
lokal Male [MeSH]
lokal Tuberculosis, Gastrointestinal/complications [MeSH]
lokal Intestinal tuberculosis
lokal Tuberculosis, Gastrointestinal/drug therapy [MeSH]
lokal Intestinal Perforation/surgery [MeSH]
lokal Tuberculosis, Gastrointestinal/diagnosis [MeSH]
lokal Case Report
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