Tuberculosis (TB) is a potentially fatal disease that can affect virtually any organic system. Intestinal TB is an uncommon form of extrapulmonary disease, with nonspecific clinical features, which can simulate Crohn's disease (CD). The differential diagnosis between the two is difficult but extremely important since the therapeutic and prognostic approach is completely distinct. We present the case of a 58-year-old woman with complaints of abdominal pain, fever and bloody diarrhoea for 5 days. The previous history of limited episodes of abdominal pain and diarrhoea, assumed as uncomplicated recurrent gastroenteritis, for the past 1 year. Colonoscopy revealed multiple ulcerated lesions, suggestive of Crohns disease. Histopathology also favoured the diagnosis of CD. However, an additional Ziehl Neelson staining of the biopsies was solicited, showing the presence of Koch bacillus. Intestinal Tuberculosis was admitted and patient-initiated antituberculous therapy.
This case report evidences the importance of a high level of suspicion of intestinal TB when evaluating a patient with features favouring a CD diagnosis, once treatment based on misdiagnosis may lead to serious morbidity and mortality.
Key words: Intestinal tuberculosis, Crohn´s Disease, Inflammatory bowel disease
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