Tuberculous enteritis. Review of a protean disease

Prior to the advent of antituberculosis drugs, at least 70% of patients with far advanced pulmonary tuberculosis had tuberculous enteritis. Despite the effectiveness of drug therapy, overt cases of tuberculous enteritis occur in the United States and particularly among immigrants from endemic areas. Clinicians often forget to consider this entity. The patient may have no or minimal abdominal complaints. Vague abdominal distress, anorexia and weight loss can be overlooked because of the extensive pulmonary exudative or cavitary disease. Even after an enteric lesion is identified, often it is mistaken for other entities, particularly neoplasm or Crohn's disease. Obviously, the diagnosis is difficult but certain radiological criteria can be indicative of the disease. This report demonstrates the protean manifestations of this entity, the complications which occur despite drug therapy and the need for continued awareness of its existence.