title: [Severe ileocolitis refractory to standard medical treatment. A diagnostic dilemma].
abstract: The differential diagnosis of granulomatous intestinal diseases leads to recurrent false diagnoses. Our patient who was presenting with gastrointestinal complaints was first diagnosed as having Crohn's disease. Put on an immunosuppressive treatment, the symptoms deteriorated. Examination of sputum revealed acid-fast bacilli, later confirmed as M. tuberculosis in culture, and colonoscopy showed necrotizing granulomas, which lead us to the final diagnosis of abdominal tuberculosis. Our patient improved under an adequate tuberculostatic regime.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hofer
authors.forename: S
authors.initials: S
authors.lastname: Schmiedel
authors.forename: A W
authors.initials: AW
authors.lastname: Lohse
authors.forename: G D
authors.initials: GD
authors.lastname: Burchard
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D003424:Crohn Disease / Q000175:diagnosis* / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004351:Drug Resistance; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents