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[Neck swelling as the major symptom of lymph node and intestinal tuberculosis]
1Medizinische Klinik II, Zentrum Innere Medizin, Dr.-Horst-Schmidt-Klinikum, Ludwig-Erhard-Strasse 100 65199 Wiesbaden. Med2.hsk-wiesbaden@knuut.de
Background:
Gut tuberculosis appears to be a rare diagnosis in Central Europe. The main diagnostic method is endoscopy with biopsy in order to win histology and a culture. By means of endoscopy the differential diagnosis to Crohn's disease is sometimes difficult. Computertomography and/or ultrasound can facilitate the diagnosis of gut tuberculosis.
Case Report:
A 64-year-old woman presented in our hospital with cervical lymph nodes and ulcerations in the cecum and near the ileocecal valve. Major symptoms were abdominal pain, loss of weight, diarrhea and febrile temperature. Histology and culture revealed tuberculosis. The common antituberculotic therapy had to be stopped due to severe allergic reaction. After desensitization the patient could be treated successfully with a triple antituberculotic therapy without further complication.
Conclusion:
Beside the early treatment with tuberculotic drugs it is very important to consider the differentiation of a gut tuberculosis.