Tuberculosis terminal ileitis: A forgotten entity mimicking Crohn's disease.
Intestinal tuberculosis (TB) is an uncommon lesion for which differential diagnosis can be difficult. We present a case of a 53-year-old male and a systematic review of the literature, from clinical symptoms to differential diagnosis, unusual complications and therapy. The patient was admitted to the hospital with signs of acute abdomen as a result of a perforated terminal ileitis. Based on the skip lesions of the terminal ileum and cecum, Crohn's disease (CD) was clinically suspected. An emergency laparotomy and right colectomy with terminal ileum resection was performed and systematic antibiotherapy was prescribed. The patient's status deteriorated and he died 4 d after the surgical intervention. At the autopsy, TB ileotyphlitis was discovered. The clinical criteria of the differential diagnosis between intestinal TB and CD are not very well established. Despite the large amount of published articles on this subject, only 50 papers present new data regarding intestinal TB. Based on these studies and our experience, we present an update focused on the differential diagnosis and therapy of intestinal TB. We highlight the importance of considering intestinal TB as a differential diagnosis for inflammatory bowel disease. Despite the modern techniques of diagnosis and therapy, the fulminant evolution of TB can still lead to a patient's death.
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania.
Simona
S
Gurzu
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania.
Calin
C
Molnar
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania.
Anca Otilia
AO
Contac
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania.
Annamaria
A
Fetyko
Simona Gurzu, Calin Molnar, Anca Otilia Contac, Annamaria Fetyko, Ioan Jung, Department of Pathology, University of Medicine and Pharmacy, 540139 Tirgu-Mures, Romania.
Ioan
I
Jung
Autopsy; Crohn’s disease; Ileitis; Ileotyphlitis; Inflammatory bowel disease; Ischemic colitis; Tuberculosis
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