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Nonhealing oesophageal ulcer: a case report.
Ram Bdr Gurung1, Prakash Sapkota1, Pasand Sharma1
1Department of Internal Medicine.
Annals of Medicine and Surgery (2012)
|June 26, 2023
Summary
Esophageal tuberculosis, a rare infection, often presents challenges in diagnosis due to non-specific findings. This case highlights diagnosis confirmation through response to antitubercular treatment in resource-limited settings.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Pulmonology
Background:
- Esophageal tuberculosis is an uncommon manifestation of a widespread infectious disease.
- It can arise as a primary infection or secondary to mediastinal lymph node involvement.
- Diagnosis is often complex due to nonspecific findings and difficulties in isolating Mycobacterium tuberculosis.
Purpose of the Study:
- To present a rare case of esophageal tuberculosis secondary to mediastinal lymphadenitis.
- To highlight an alternative diagnostic approach in resource-limited settings.
Main Methods:
- Case report of a 50-year-old male with dysphagia.
- Diagnostic tools included endoscopy, histopathology, and computed tomography.
- Definitive diagnosis was established via response to a trial of antitubercular treatment.
Main Results:
- The patient presented with dysphagia and epigastric burning.
- Endoscopy revealed esophageal ulceration; histopathology showed granulomatous inflammation.
- Computed tomography indicated enlarged mediastinal lymph nodes, but acid-fast bacilli stains were negative.
- Significant ulcer healing occurred after two months of antitubercular therapy.
Conclusions:
- Esophageal tuberculosis, secondary to mediastinal lymphadenitis, can manifest as dysphagia.
- In resource-limited areas, tuberculosis should be a differential diagnosis.
- Clinical judgment and response to antitubercular treatment may be crucial for diagnosis.
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