Intestinal tuberculosis in a 36-year-old female patient
This article describes the case of a 36-year-old female patient diagnosed with intestinal tuberculosis. The patient presented to the emergency department with a 1-day history of severe abdominal pain and fever and cough with a 2-day history. She worked as a physician and had no significant medical history. The examination was consistent with diffuse, severe abdominal tenderness with rebound and guarding.
Doctors further advised a computed tomography of the chest which showed a miliary pattern of pulmonary nodules and the presence of free air in the subdiaphragmatic region. بيتواي The patient was immediately referred to the operating room. Gross pathological examination showed six perforations in the terminal ileum. Treatment included resection of the distal ileum with an ileostomy. The patient was further referred for a histopathological examination of the necrotizing granulomatous inflammation. The patient was tested for Myobacterium tuberculosis. Cultures and real-time polymerase-chain-reaction testing of the intestinal tissue and peritoneal fluid was positive for Myobacterium tuberculosis. Based on these findings, the patient was diagnosed with disseminated tuberculosis and tuberculous ileitis.
Histopathological examination was significant for submucosal necrotizing granulomatous inflammation. Doctors further advised cultures and real-time polymerase chain reaction testing. Investigation findings were significant for Mycobacterium tuberculosis. Based on these findings, the patient was diagnosed with disseminated tuberculosis with tuberculous ileitis. The patient tested negative for human immunodeficiency virus. Previous studies have shown that the ileocecal area is the most commonly involved region in cases of intestinal tuberculosis. The infection may also be misdiagnosed as appendicitis or inflammatory bowel disease. لربح المال For treatment, doctors advised 9 months of antituberculous treatment and after 6 months underwent her first ileostomy operation. روليت اون لاين The patient was called back for a follow-up 12 months after her initial presentation and showed complete recovery.
Source: NEJM
