Korean J Gastroenterol.  2002 Apr;39(4):299-303.

A Case of Cure with Secondary Rescue Regimen of Tuberculosis in a Patient with Tuberculous Colitis that Failed to Respond to Primary Drugs

• Ko BS
• Kim BG
• Kim JS
• Jung HC
• Song IS

Abstract

Recently, the incidence of pulmonary tuberculosis has increased. In addition, extrapulmonary tuberculosis and multi-drug resistant tuberculosis have also increased. We experienced a 34-year-old male with intestinal tuberculosis which failed to respond to primary anti-tuberculosis therapy. He presented with loose stool, abdominal pain, and weight loss. The caseating granuloma was histologically found. The patient had taken primary anti-tuberculosis drugs for 13 months. However, his symptoms and weight loss did not improve. A colonoscopy showed multiple shallow geographic ulcerations in the cecum and ileocecal valve. Histopathologic examination also showed caseating granuloma. We started primary anti-tuberculosis therapy (isoniazid, rifampin, ethambutol, pyrazinamide), but follow-up colonoscopic findings after 2 months revealed no change of multiple ulcerations. After conversion of anti-tuberculosis therapy from primary drugs to secondary rescue regimen (prothionamide, cycloserine, para-aminosalicylic acid, levofloxacin, streptomycin), the patient's symptoms have improved. A follow-up colonoscopy revealed only scarring change in the cecum.

Keyword

Intestinal tuberculosis; Drug resistance

MeSH Terms

Abdominal Pain
Adult
Aminosalicylic Acid
Cecum
Cicatrix
Colitis*
Colonoscopy
Cycloserine
Drug Resistance
Ethambutol
Follow-Up Studies
Granuloma
Humans
Ileocecal Valve
Incidence
Levofloxacin
Male
Rifampin
Tuberculosis*
Tuberculosis, Multidrug-Resistant
Tuberculosis, Pulmonary
Ulcer
Weight Loss
Aminosalicylic Acid
Cycloserine
Ethambutol
Rifampin