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:: Volume 26, Issue 1 (Scientific Journal of Kurdistan University of Medical Sciences 2021) ::
SJKU 2021, 26(1): 139-146 Back to browse issues page
Intestinal Tuberculosis or Crohn's Disease: A Diagnostic Challenge Case Report
Ali Najafpour 1, Leila Hamzelou2 , Babak Sayad3
1- Student research Committee, Faculty of Medicine, Kermanshah University of Medical Sciences. Kermanshah, Iran , ali98aaa@yahoo.com
2- Infectious Diseases Research Center, Kermanshah University of Medical Sciences. Kermanshah, Iran
3- Department of Infectious Disease, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
Abstract:   (196 Views)
Background and Aim: Crohn's disease is a chronic idiopathic disease in the category of gastrointestinal tract inflammation without any obvious reason. Clinical signs include abdominal pain, and diarrhea, which may be accompanied by a fistula or intestinal obstruction. Differential diagnosis of Crohn's disease and intestinal tuberculosis is a complex and difficult challenge.
Case presentation: The patient was a 70-year-old woman who had been hospitalized due to fistulas with 4 years of discharge in the left inguinal and gluteal area. The patient's vital signs were stable, and she did not report any fever, chills, or gastrointestinal symptoms. Diagnostic tuberculosis procedures were performed for this patient and despite the lack of evidence in favor of intestinal tuberculosis, experimental tuberculosis treatment was started for him. Despite 10 months of anti-tuberculosis treatment, the symptoms and fistulas of the patient did not recover in 2016. On spiral computed tomography scan of the lung and mediastinum without injection, the presence of cardiomegaly, evidence of ground glass was seen along with an increased thickness of the interlobular septa in the middle lobe of the right lung and ground-glass opacities at the base of both lungs. Since the patient had typical intestinal tuberculosis symptoms, discharge cultivation and smear were performed and it did not grow on Mycobacterium tuberculosis bacillus acid staining. The patient underwent biopsy with MR Enterography, and Crohn's diagnosis was confirmed. The patient was treated with Metronidazole, Ciprofloxacin, and a combination of Azathioprine and Infliximab.
Conclusion: According to the rare case reported, advanced diagnostic measures should be taken in dealing with patients with intestinal tuberculosis or Crohn disease
Keywords: Crohn’s disease, Differential diagnosis, Intestinal tuberculosis
Full-Text [PDF 616 kb]   (58 Downloads)    
Type of Study: case report | Subject: Medicine - Infectious
Received: 2020/07/21 | Accepted: 2020/12/20 | Published: 2021/03/30
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Najafpour A, Hamzelou L, Sayad B. Intestinal Tuberculosis or Crohn's Disease: A Diagnostic Challenge Case Report. SJKU. 2021; 26 (1) :139-146
URL: http://sjku.muk.ac.ir/article-1-6184-en.html


Volume 26, Issue 1 (Scientific Journal of Kurdistan University of Medical Sciences 2021) Back to browse issues page
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
مجله علمی دانشگاه علوم پزشکی کردستان Scientific Journal of Kurdistan University of Medical Sciences
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