Intestinal Tuberculosis in an Immunocompetent Patient: A Case Report
DOI:
https://doi.org/10.52787/agl.v54i1.341Keywords:
Intestinal tuberculosis, immunocompetenceAbstract
Intestinal tuberculosis is an infrequent pathology. Although it has a low incidence, it is on the rise due to the increase in the number of cases of HIV infection, resistance to anti-tuberculosis drugs, and migratory changes. Sometimes diagnosis is difficult for physicians given its clinical heterogeneity. It can mimic other intestinal diseases, and therefore its detection and start of treatment are often late. For this reason, the diagnosis is usually made in advanced or severe stages. We present the case of a 53-year-old immunocompetent woman with fever, general repercussions, respiratory symptoms, and diarrhea of 3 months' evolution. Video colonoscopy showed lesions in the cecum with biopsies confirming Mycobacterium tuberculosis, also present in respiratory samples. Despite initiating anti-tuberculosis treatment, the patient presented intestinal perforation with poor evolution and death.
References
-1. WHO. Global tuberculosis report 2022. Ginebra: World Health organization; 2022. Disponible en: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
-2. chlaep.org.uy. [internet]. Datos nacionales, situación de tuberculosis en Uruguay 2021, sitio web disponible en: https://chlaep.org.uy/programa-nacional-de-control-de-tuberculosis/estadisticas/
-3. Miranda L, Lanz C, Nozar F. Tuberculosis abdominal. Rev. Méd. Urug. [Internet]. [citado 10 de mayo de 2021]. 2012;28(3):199-04. Disponible en: https://revista.rmu.org.uy/index.php/rmu/article/view/340
-4. Machuca I, Vidal E, de la Torre-Cisneros J. Tuberculosis en pacientes inmunodeprimidos. Enferm Infecc Microbiol Clin. 2018;36(6):366-74.
-5. Choi EH, Coyle WJ. Gastrointestinal Tuberculosis. Microbiol Spectr. 2016;4(6).
-6. Horvath KD, Whelan RL. Intestinal tuberculosis: return of an old disease. Am J Gastroenterol.1998;93(5):692-6.
-7. Muneef MA, Memish Z, Mahmoud SA, et al. Tuberculosis in the belly: a review of forty-six cases involving the gastrointestinal tract and peritoneum. Scand J Gastroenterol. 2001;36(5):528-32.
-8. Wu DC, Averbukh LD, Wu GY. Diagnostic and Therapeutic Strategies for Peritoneal Tuberculosis: A Review. J Clin Transl Hepatol. 2019;7(2):140-8.
-9. CHLAEP. Guía nacional para el manejo de la tuberculosis. Montevideo: CHLAEP, tercera edición, noviembre de 2016. Disponible en: https://chlaep.org.uy/wp-content/uploads/2018/08/guia-nacional-para-el-manejo.pdf
-10. Jehangir W, Khan R, Gil C, Baruiz-Creel M, Bandel G, Middleton JR, Sen P. Abdominal Tuberculosis: An Immigrant's Disease in the United States. N Am J Med Sci. 2015;7(6):247-52.
-11. Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol. 1977;67(4):324-37. PMID: 879148.
-12. Barzegari S, Afshari M, Movahednia M, et al. Prevalence of anemia among patients with tuberculosis: A systematic review and meta-analysis. Indian J Tuberc. 2019;66(2):299-307.
-13. Sato S, Yao K, Yao T, Schlemper RJ, Matsui T, et al. Colonoscopy in the diagnosis of intestinal tuberculosis in asymptomatic patients. Gastrointest Endosc. 2004;59(3):362-8.
-14. Kirsch R, Pentecost M, Hall Pde M, Epstein DP, Watermeyer G, Friederich PW. Role of colonoscopic biopsy in distinguishing between Crohn's disease and intestinal tuberculosis. J Clin Pathol. 2006;59(8):840-4.
-15. Maulahela H, Simadibrata M, Nelwan EJ, et al. Recent advances in the diagnosis of intestinal tuberculosis. BMC Gastroenterol. 2022;22(1):89.
-16. Sefr R, Rotterová P, Konecný J. Perforation peritonitis in primary intestinal tuberculosis. Dig Surg. 2001;18(6):475-9.
-17. Nguyen VH. Intestinal obstruction due to tuberculosis. Asian J Surg. 2002; 25(2):145-8.
-18. Bernhard J S, Bhatia G, Knauer C M. Gastrointestinal tuberculosis: an eighteen-patient experience and review. J Clin Gastroenterol.2000;30:397-402.
-19. Govind M, Uday G, Balakrishnan R, et al. Intermittent Directly Observed Therapy for Abdominal Tuberculosis: A Multicenter Randomized Controlled Trial Comparing 6 Months Versus 9 Months of Therapy. Clinical Infectious Diseases. 2015;61(5):750-7.
-20. Goldani L Z, Spessatto C O, Nunes DL, et al. Management of Severe Gastrointestinal Tuberculosis with Injectable Antituberculous Drugs. Trop Med Health.2015;43(3):191-4.

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