title: [Ileocecal tuberculosis during hemodialysis simulating carcinoma of the colon].
abstract: Extrapulmonary tuberculosis is more frequent in hemodialysis patients than in the general population but intestinal localization is an unusual presentation of this infectious disease. We report a 60 year old patient on regular hemodialysis with intestinal tuberculosis masquerading as colon cancer. The patient presented with rectal bleeding, abdominal pain and fever and the radiological findings were compatible with ileocecal carcinoma. After surgery histological examination showed non-caseating granulomas but mycobacterial culture was not available. We performed a colonoscopy and obtained a biopsy of colonic mucosa for culture and other analyses. We identified acid-fast bacilli with Ziehl-Neelsen staining of formaldehyde preserved, paraffin-embedded tissue from the hemicolectomy and the colonic mucosal biopsy. Treatment with isoniazid, rifampicin and pyrazinamide for nine months was successful and well tolerated. Intestinal tuberculosis is a rare entity that we must keep in mind in a patient with abdominal pain, unexplained fever, digestive bleeding and particularly with a positive tuberculin reaction. When culture is not possible we can obtain intestinal samples by colonoscopy and use appropriate staining of paraffin-embedded tissues.
authors.affiliation: Servicio de Nefrología, Hospital General de Especialidades Ciudad de Jaén, Jaén.
authors.forename: S
authors.initials: S
authors.lastname: García Marcos
authors.forename: F J
authors.initials: FJ
authors.lastname: Borrego
authors.forename: J M
authors.initials: JM
authors.lastname: Martínez de la Victoria
authors.forename: C
authors.initials: C
authors.lastname: Sánchez Perales
authors.forename: M J
authors.initials: MJ
authors.lastname: García Cortés
authors.forename: P
authors.initials: P
authors.lastname: Pérez del Barrio
authors.forename: L
authors.initials: L
authors.lastname: Parras
authors.forename: V
authors.initials: V
authors.lastname: Pérez Bañasco
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary; D002429:Cecal Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D002763:Cholecystectomy; D003082:Colectomy; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005334:Fever / Q000209:etiology; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D007416:Intestinal Perforation / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008551:Melena / Q000209:etiology; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary; D014395:Peritonitis, Tuberculous / Q000175:diagnosis; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications; D006435:Renal Dialysis; D014375:Tuberculoma / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000601:surgery