[Clinical differentiation between intestinal tuberculosis and morbus Crohn]

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Intestinal tuberculosis is a significant global health concern, often presenting with non-specific gastrointestinal symptoms that can mimic other conditions.
• Early and accurate diagnosis is crucial for effective management and preventing complications.

Observation:

• A 34-year-old Indonesian woman presented with chronic diarrhea, weight loss, fever, and night sweats.
• Colonoscopy revealed a cobblestone pattern of necrosis in the colon, and MR imaging showed small intestine edema and abdominal lymphadenopathy.
• The patient had a history of tuberculosis (TB) exposure and a positive T-SPOT-TB test.

Findings:

• The patient received a standard four-drug tuberculosis treatment regimen.
• Clinical improvement was rapid following the initiation of anti-TB therapy.
• Subsequent fecal culture confirmed the presence of Mycobacterium tuberculosis.

Implications:

• This case underscores the importance of considering intestinal tuberculosis in patients with compatible symptoms, especially in endemic regions.
• Diagnostic tools like colonoscopy, MR imaging, and T-SPOT-TB are valuable in identifying intestinal TB.
• Timely and appropriate anti-TB treatment leads to favorable outcomes.