[Cecal Tuberculosis Caused by Mycobacterium caprae Simulating Carcinoma: A Case Report and Review of the Literature]

Abdominal tuberculosis is a form of extrapulmonary tuberculosis that frequently involves the ileocecal region and often mimics conditions such as colorectal cancer or inflammatory bowel disease due to its nonspecific symptoms. While Mycobacterium tuberculosis remains the most common causative agent, rare zoonotic species like Mycobacterium caprae can also lead to human disease. In this case report, a rare case of cecal tuberculosis caused by M.caprae in a 46-year-old woman with a healthy immune system was presented. The patient presented chronic abdominal pain, diarrhea and weight loss for two years. Radiological imaging revealed ileocecal thickening and colonoscopy showed an ulcerovegetative mass raising suspicion of malignancy. Histopathological examination showed chronic granulomatous inflammation with acid-fast bacilli and molecular testing confirmed the presence of M.caprae. The patient was treated with standard anti-tuberculosis therapy including isoniazid, rifampicin, pyrazinamide and ethambutol. However, due to the development of post-treatment intestinal stenosis, surgical intervention was necessary. Human diseases with M.caprae are exceedingly rare and typically associated with occupational or environmental exposure to infected animals or unpasteurized dairy products. In this case, no such exposure was identified. The case highlights the diagnostic challenges posed by intestinal tuberculosis and underscores the importance of considering mycobacterial infections even in immunocompetent hosts. Early recognition and molecular identification are essential for accurate diagnosis and appropriate treatment. Clinicians should remain alert to potential complications such as fibrotic strictures that may require surgical management. This case represents one of the rare reports in the literature of cecal tuberculosis caused by M.caprae. To the best of our knowledge, reports describing similar cases are exceedingly rare.