[Small bowel perforation caused by intestinal dissemination of pulmonary tuberculosis due to biological therapy]

Case review: The authors present a case of a 78-year-old female patient who previously, as a teenager, had been treated for pulmonary tuberculosis. The biological therapy for subsequent inflammatory bowel disease in 2015 caused a flare up of the respiratory symptoms after 60 years of being asymptomatic, and the patient also developed acute abdomen. She required emergency laparotomy and small intestine segment resection was performed due to perforated ileum. Histological examination of the specimen showed intestinal tuberculosis as the cause of perforation. Following pharmacological therapy in the postoperative period the patient eventually became asymptomatic. Discussion: Tuberculosis is a life threatening disease which can virtually affect any organ system. The primary site of tuberculosis is usually the lung, from which it can get disseminated into other parts of the body. With this article we would like to raise the awareness of the potentially lethal side effects of biological and immune modulated therapies and we would also like to emphasize the importance of the cooperation of practitioners in different medical fields.