GE: Portuguese Journal of Gastroenterology (Dec 2019)

Gastrointestinal Tuberculosis Mimicking Crohn’s Disease

  • Maria Ana Rafael,
  • Luísa Martins Figueiredo,
  • Ana Maria Oliveira,
  • Mariana Nuno Costa,
  • Rita Theias Manso,
  • Alexandra Martins

DOI
https://doi.org/10.1159/000504719

Abstract

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We present the case of a 24-year-old woman with complaints of abdominal pain, bloody diarrhea, and weight loss for 3 months. An outpatient colonoscopy revealed scattered ulcers, suggestive of Crohn’s disease (CD). Histopathology also favored the diagnosis of CD. However, after admission to our hospital for further investigation, a chest radiograph revealed pulmonary cavitations. A computed tomography scan suggested the diagnosis of active pulmonary tuberculosis (TB). Therefore, a bronchofibroscopy, a total colonoscopy with ileoscopy, and an upper endoscopy were performed. Not only were acid-fast bacilli present in both bronchoalveolar lavage fluid and gastric juice, but also in colonic biopsies. A complete resolution of gastrointestinal symptoms was achieved 2 weeks after starting anti-TB drugs.

Keywords