title: Two cases of colonic tuberculosis presenting with massive melena.
abstract: The clinical symptoms of colonic tuberculosis are variable, among which massive melena is extremely rare. Herein, we report two cases of colonic tuberculosis representing with massive melena, both of whom never had active pulmonary tuberculosis. The first case was a 55-year-old woman. Although her emergency colonoscopic setting suggested colonic tuberculosis, no evidence of tuberculosis could be found at that time. We performed a therapeutic trial and observed a drastic regression of the initial changes with 4-week treatment using antituberculous agents. The second case was a 37-year-old man. His emergency colonoscopy showed lesions mimicking colon carcinoma. However, the histological examinations did not indicate malignancy. The polymerase chain reaction of colonic biopsy specimen was positive for Mycobacterium tuberculosis. Similar to the first case, a significant improvement of the initial lesions was observed after 4-week treatment using antituberculous agents. Collectively, although the massive melena is a rare manifestation, tuberculosis of the colon should be suspected in the patients with such symptom.
authors.affiliation: Third Department of Internal Medicine, Nara Medical University, Nara, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Namisaki
authors.forename: H
authors.initials: H
authors.lastname: Yoshiji
authors.forename: M
authors.initials: M
authors.lastname: Fujimoto
authors.forename: H
authors.initials: H
authors.lastname: Kojima
authors.forename: K
authors.initials: K
authors.lastname: Yanase
authors.forename: M
authors.initials: M
authors.lastname: Kitade
authors.forename: Y
authors.initials: Y
authors.lastname: Ikenaka
authors.forename: M
authors.initials: M
authors.lastname: Toyohara
authors.forename: J
authors.initials: J
authors.lastname: Yamao
authors.forename: T
authors.initials: T
authors.lastname: Tsujimoto
authors.forename: T
authors.initials: T
authors.lastname: Tsuruzono
authors.forename: H
authors.initials: H
authors.lastname: Kitano
authors.forename: K
authors.initials: K
authors.lastname: Matsumura
authors.forename: Y
authors.initials: Y
authors.lastname: Matsumura
authors.forename: H
authors.initials: H
authors.lastname: Fukui
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D003108:Colonic Diseases / Q000150:complications* / Q000188:drug therapy; D003110:Colonic Neoplasms / Q000382:microbiology; D003113:Colonoscopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008551:Melena / Q000188:drug therapy / Q000382:microbiology*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D016896:Treatment Outcome; D014385:Tuberculosis, Gastrointestinal / Q000150:complications* / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents