Gastrointestinal Tuberculosis: Clinical Presentations and Diagnostic Approaches

Area of Science:

• Gastroenterology
• Infectious Diseases
• Public Health

Background:

• Gastrointestinal tuberculosis (GI TB) is a rare extrapulmonary form of tuberculosis.
• It frequently mimics other gastrointestinal conditions like Crohn's disease or malignancies.
• GI TB is underrecognized in low-incidence countries like Germany, exacerbated by rising migration.

Purpose of the Study:

• To evaluate diagnostic tools for GI TB.
• To propose a diagnostic approach to reduce delays and avoid unnecessary interventions.
• To improve recognition of GI TB in low-incidence settings.

Main Methods:

• Retrospective analysis of eight patients with suspected GI TB.
• Detailed case descriptions of two recent challenging cases.
• Evaluation of diagnostic performance of microscopy, culture, histopathology, and PCR.

Main Results:

• GI TB confirmed in 62.5% of suspected cases.
• Abdominal complaints and systemic symptoms were common.
• Histopathology confirmed all GI TB cases; PCR was positive in 4/5 cases; microscopy was positive in only one case.

Conclusions:

• GI TB poses a diagnostic challenge due to its mimicry of other GI diseases.
• Early histopathology and PCR are critical for timely GI TB diagnosis.
• Clinicians in low-incidence settings must maintain high suspicion in at-risk populations.