title: [Synchronous intestinal, tonsillar and pulmonary tuberculosis].
abstract: OBJECTIVE
  To emphasize the unusual synchronous presentation of intestinal, pulmonary and tonsillar tuberculosis in the same patient.
  
  
  METHODS
  A 43 years old male consults for abdominal pain and alternating episodes of diarrhoea-constipation. Based on radiologic, endoscopic and pathologic studies the diagnosis of Crohn's ileo-cecal disease is achieved and a treatment with salazosulphapyridine and corticosteroid is started. Two months later the patient presents with a tonsilar ulceration that is diagnosed as tuberculosis on biopsy material. At the same time, chest x-rays film reveal active tuberculous lesions, and tuberculous bacili are seen in the sputum. Simultaneously the intestinal disease worsens and complicates with incomplete occlusion that requires a right hemicolectomy. Pathologic study of the specimen shows evident tuberculous lesions. Specific treatment for tuberculosis is started, and the patient remains free of disease one year later.
  
  
  CONCLUSIONS
  Due to the increase in the prevalence of tuberculous diseases, we must keep it in mind in the differential diagnosis of intestinal strictures, even though they are suggestive of Crohn's disease, and a radical surgical procedure must also be evaluated.
authors.affiliation: Servicio de Cirugía General, Hospital San Agustín, Linares (Jaén).
authors.forename: J
authors.initials: J
authors.lastname: Díaz Oller
authors.forename: R
authors.initials: R
authors.lastname: Cano Muñoz
authors.forename: M E
authors.initials: ME
authors.lastname: Fuentes Vaamonde
authors.forename: E
authors.initials: E
authors.lastname: Soler Lluch
authors.lastname: Díaz Iglesias
authors.forename: M T
authors.initials: MT
authors.lastname: Medina Domínguez
authors.forename: A
authors.initials: A
authors.lastname: Arcos Navarro
authors.forename: R
authors.initials: R
authors.lastname: Moya Vázquez
authors.forename: P
authors.initials: P
authors.lastname: Aljama de la Lastra
mesh_terms: D000328:Adult; D001706:Biopsy; D003082:Colectomy; D003108:Colonic Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology; D010608:Pharyngeal Diseases / Q000150:complications / Q000175:diagnosis; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D014385:Tuberculosis, Gastrointestinal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis
vernacular_title: Tuberculosis intestinal, amigdalar y pulmonar sincrónicas.