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Tuberculous colitis mimicking Crohn's disease

Arnold, Christian, MD1; Moradpour, Darius, MD1; Blum, Hubert E, MD1,*

American Journal of Gastroenterology: November 1998 - Volume 93 - Issue 11 - p 2294–2296
doi: 10.1111/j.1572-0241.1998.00644.x
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Intestinal tuberculosis is a rare disease in western countries and may mimic a variety of gastrointestinal disorders. Here, we report the case of a 63-yr-old patient who presented with profuse bleeding from a deep rectal ulcer. Similar lesions were found in different parts of the colon. Multilocular colorectal carcinoma was suspected based on the macroscopic appearance. Histology, however, suggested Crohn's disease. Intestinal tuberculosis was initially ruled out by negative staining for acid-fast bacilli, mycobacterial culture, and polymerase chain reaction analysis. A treatment for Crohn's disease was started. Endoscopic reexamination revealed progressive disease with extensive ulcerations of the terminal ileum. Histopathological examination then revealed acid-fast bacilli in the colonic mucosa typical for mycobacterium tuberculosis infection. This case emphasizes the need to include intestinal tuberculosis in the initial differential diagnosis of ulcerative colorectal lesions also in the western population.

1Department of Medicine II, University of Freiburg, Freiburg, Germany

*Department of Medicine II, University of Freiburg, Hugstetter Strasse 55, D-79106 Freiburg, Germany

© The American College of Gastroenterology 1998. All Rights Reserved.
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