Ewha Med J.  2021 Jul;44(3):93-96. 10.12771/emj.2021.44.3.93.

Differentiating between Intestinal Tuberculosis and Crohn’s Disease May Be Complicated by Multidrug-resistant Mycobacterium tuberculosis

• Hong SW
• Park SH
• Ye BD
• Yang SK

• KMID: 2518773
• DOI: http://doi.org/10.12771/emj.2021.44.3.93

Abstract

Differentiating between intestinal tuberculosis (ITB) and Crohn’s disease (CD) remains a challenge for gastroenterologists. In Asia, where the prevalence of tuberculosis is relatively high and the incidence of CD is rapidly increasing, this issue is crucial. Here we report a case that was initially misdiagnosed as CD, subsequently showed no response to empirical first-line anti-tuberculosis medication, and was finally diagnosed with multidrug-resistant ITB. This case reminds physicians that multidrug-resistant ITB may complicate distinguishing between ITB and CD

Keyword

Crohn’s disease; Gastrointestinal tuberculosis; Multidrug-resistant tuberculosis

Figure

• 

  Fig. 1 Serial colonoscopy findings. (A) Initial colonoscopy performed in another hospital reveals multiple transverse ulcers in the ascending colon. (B) Follow-up colonoscopy performed 11 weeks after commencement of the first anti-tuberculosis therapy still shows multiple transverse ulcers in the ascending colon. (C) Follow-up colonoscopy performed 25 weeks after commencement of the first anti-tuberculosis therapy still shows multiple transverse ulcers in the ascending colon. (D) Follow-up colonoscopy performed 28 weeks after therapy for multidrug-resistant intestinal tuberculosis shows only scarring and no active ulcers. A written informed consent for publication and use of medical data and images was obtained from the patient.

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