[Intestinal tuberculosis: Easier overlooked than diagnosed]

Area of Science:

• Gastroenterology
• Infectious Diseases
• Medical Diagnostics

Background:

• Intestinal tuberculosis (ITB) presents diagnostic challenges due to its similarity to Crohn's disease.
• Clinical presentation, endoscopic findings, and histology can be indistinguishable from other inflammatory bowel diseases.
• Asian immigrants are a demographic where ITB should be considered due to higher prevalence.

Observation:

• Two cases of Asian immigrants with ITB highlight the diagnostic difficulties.
• Symptoms and intestinal findings in ITB closely resemble those of Crohn's disease.
• Standard diagnostic methods may not always yield a definitive diagnosis promptly.

Findings:

• Sonography, radiology, endoscopy, and histology aid in differentiating ITB from Crohn's disease.
• Definitive diagnosis relies on identifying Mycobacterium tuberculosis in tissue specimens.
• Microorganism identification can be difficult and time-consuming.

Implications:

• Awareness of ITB's mimicry of Crohn's disease is essential for clinicians.
• A therapeutic trial with anti-tuberculous agents may be a pragmatic approach when diagnosis is uncertain.
• Prompt and accurate diagnosis of ITB is vital for effective treatment and patient outcomes.