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Duodenal ulcers preceding cervical tuberculous lymphadenitis
M Curioni1, L Airaghi, M Barcella
1First Division of Internal Medicine, Padiglione Granelli, IRCCS Ospedale Maggiore Policlinico, Via F. Sforza 35, IT-20122 Milan, Italy. lairagh@tin.it
Scandinavian Journal of Gastroenterology
|September 17, 2004
Summary
Gastrointestinal tuberculosis is rare, but this case highlights cervical lymphadenitis and duodenitis in an HIV-negative patient. Tuberculous infection should be considered for refractory duodenal ulcers, especially in endemic areas.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pulmonology
Background:
- Extrapulmonary tuberculosis (TB) commonly presents as lymphadenitis, but gastrointestinal involvement, particularly duodenal TB, is infrequent.
- Tuberculosis is a significant global health concern, with extrapulmonary manifestations posing diagnostic challenges.
Observation:
- A case of a human immunodeficiency virus-seronegative adult woman from an endemic area presented with cervical lymphadenitis and duodenitis with multiple ulcers.
- The duodenal ulcers were unresponsive to standard proton pump inhibitor therapy.
Findings:
- This case demonstrates a rare association between cervical lymphadenitis and duodenitis.
- The diagnostic difficulties and etiological factors of duodenal tuberculosis were analyzed in the context of existing literature.
Implications:
- The findings suggest that tuberculous infection should be considered in the differential diagnosis of duodenal ulcers that do not respond to proton pump inhibitors, particularly in individuals from TB-endemic regions.
- Early consideration of TB can lead to timely diagnosis and appropriate treatment, improving patient outcomes.