Tuberculosis Enteritis Research Articles

Combination of Crohn’s disease with intestinal tuberculosis

Tüberküloz gelişmekte olan ülkelerde halen önemli bir sağlık sorunudur. Ekstrapulmoner tüberküloz bir çok organı etkileyebilir. Gastrointestinal sistem tüberkülozu %3-5 ile sık izlenilmeyen bir ekstrapulmoner tüberküloz nedenidir; sıklıkla tüberküloz enteriti ve tüberküloz peritoniti olarak karşımıza çıkar. Tüberküloz enteriti ile Crohn hastalığı ayrımı önemlidir. Günümüzde Crohn hastalığının tedavisinde merkezde immünsüpresif ilaçlar yer almaktadır. Bu nedenle bu ayrım hayati önem taşımaktadır.

Rifabutin Related Uveitis in AIDS: A Case Report

Purpose: To describe a case of symptomatic rifabutin-related uveitis with hypopyon and vitreous opacity in apatient with acquired immunodeficiency syndrome infected with Mycobacterium tuberculosis. Case summary: A 33-year-old male patient with acquired immunodeficiency syndrome was referred to our clinic for abruptly decreased vision in his right eye. Multi-drug therapy with rifabutin was administered for 5 weeks to treat tuberculosis enteritis and pulmonary tuberculosis. Visual acuity of the right eye was hand motion and hypopyon as well as vitreous opacity was found in ocular examinations. Other serologic tests, anterior chamber paracentesis and lumbar puncture test were normal. Rifabutin was immediately stopped and topical steroid and cycloplegics were administered, which resulted in resolution of the hypopyon, vitreous opacity and visual acuity. Four weeks after the initial episode, rifabutin was restarted to treat the pulmonary tuberculosis and rifabutin-related uveitis relapsed in the opposite eye. Conclusions: Rifabutin-related uveitis should be considered in cases of uveitis in immunosuppressive patients, especially in acquired immunodeficiency syndrome patients. Underling disease and medication history should be carefully assessed.

Ultrasonographic Patterns of Non-neoplastic Small Bowel Diseases

Background Ultrasonography is a valuable tool in the evaluation of gastrointestinal disease by directly imaging the gut wall and the perigut region. With the recent improvement of ultrasonic machines, bowel disorders can be detected by ultrasonography prior to other imaging modalities. In this study, abdominal ultrasonography was used as the first-line tool to detect non-neoplastic small bowel disorders. Our goal was to classify the ultrasonographic patterns of diseased small bowel walls and to analyze the groups of these small bowel diseases. Patients and Methods A total of 66 patients with suspected small bowel pathology were enrolled in this study between August 1995 and February 2006. They received abdominal ultrasonography due to acute abdomen in the emergency department of National Taiwan University Hospital. Ultrasonographic patterns of diseased small bowel walls were classified as follows: Type A—palisade arrangements of edematous folds of Kerckring; Type B—short, mildly edematous, and scattering loss of folds of Kerckring; Type C1—mucosal thickening only and folds of Kerckring are not apparent; Type C2—mucosal and submucosal thickening; Type D—loss of layering structure of wall with occasional bright flecks within the wall. Results Type A included 16 patients with systemic lupus erythematosus enteropathy and one cytomegalovirus enteritis. Type B included five Aeromonas and two non-typhoid enteritis patients. Type C1 included one ischemic bowel, one protein-losing enteropathy and one Klebsiella oxytoca enteritis. Type C2 included three non-typhoid, three Henoch-Schonlein purpura, two tuberculosis enteritis, two eosinophilic enteritis, one Behcet's disease, and one Vibrio parahaemolyticus enteritis. Type D included 11 ischemic bowel, eight Crohn's disease, two tuberculosis enteritis, two nonspecific vasculitis, two nonspecific inflammation, one amyloidosis, and one case of Ascaris infestation. Conclusion Anatomic changes in the small bowel can be demonstrated by ultrasonography. However, ultrasonographic patterns are nonspecific as correlated with etiologies of non-neoplastic small bowel disease. In our study, most cases of systemic lupus erythematosus enteropathy were of ultrasonographic Type A pattern, while those of ultrasonographic Type D pattern included ischemic bowel and Crohn's disease.

Minimally Invasive Management of Obstructive Gastroduodenal Tuberculosis

Pulmonary tuberculosis (TB) is prevalent in Western urban centers, especially among immunocompromised patients and immigrants. However, TB enteritis is a rare sequela, occurring in less than 1 per cent of this population. Tuberculosis may affect any portion of the gastrointestinal (GI) tract, and 85 per cent of cases manifest in the ileocecal region. However, the stomach and duodenum are involved in just 0.3-2.3% of TB cases that affect the gut. Gastric outlet obstruction due to TB has been traditionally treated by a surgical bypass operation, followed by anti-TB chemotherapy. In a recent review of 17 cases of TB-related gastric outlet obstruction, gastrojejunostomy or duodenojejunostomy was performed in all patients. We present a case of gastric outlet obstruction due to TB that was treated successfully with a minimally invasive approach, without the need for a gastric bypass.

Tuberculosis Enteritis Presenting as a Small Bowel Obstruction

c i T s c f o r g c w c E 25-year-old healthy Indian woman presented with feer, chills, night sweats, nausea, vomiting, abdominal istention, and severe abdominal pain for 2 days. She ad intermittent abdominal pain and 60-pound weight oss for the 6 months since her arrival from India. On xamination she was afebrile, tachycardic, and had a oft, distended abdomen with diffuse tenderness, reound, and guarding. A chest x-ray showed no abnoralities. CT scan of the abdomen showed high-grade bstruction (A) with the transition point at the ilealecal region and lymphadenopathy. There was an abnorally thickened cecum (B). The patient had leukocytois of 20,000 and 47% bandemia. Because her bdominal examination worsened, she was taken to the perating room to relieve the obstruction. Our differenial diagnosis was high-grade small bowel obstruction rom previous perforated appendicitis with abscess foration, a malignant lymphoma, or tuberculosis. At laprotomy, a phlegmous process involving part of the ce-

Molecular and Histopathologic Evidence for Systemic Infection by Mycobacterium Bovis in A Patient with Tuberculous Enteritis, Peritonitis, and Meningitis: A Case Report

Mycobacterium bovis infection has been reported in several patients with AIDS in other countries. The prevalence of tuberculosis in Taiwan is higher than the World Health Organization standard. However, reports of M. bovis infection are rare. A 47-year-old male had the habit of drinking uncooked fresh deer's blood and unpasteurized deer's milk. He suffered from acute abdominal pain and underwent emergency laparotomy. Pathology demonstrated tuberculosis enteritis with colon perforation. The molecular diagnosis by nested polymerase chain reaction assay and single-strand conformation polymorphism assay showed M. bovis infection in the small intestine, mesenteric lymph nodes, and cerebrospinal fluid (CSF). Our results suggest that the most likely portal of entry of M. bovis is the gastrointestinal rather than the respiratory tract. Ingested M. bovis from unpasteurized deer's milk probably entered the mucosal macrophages of the intestine and then the draining mesenteric lymph nodes. As immunity declined, bacilli from the mesenteric lymph nodes disseminated to other organs and into the CSF.

Exacerbation of mycobacterium tuberculosis enteritis masquerading as crohn’s disease after treatment with a tumor necrosis factor-α inhibitor

Infliximab (Remicade; Centocor, Inc, Malvern, Pennsylvania), a chimeric monoclonal antibody to tumor necrosis factor-α (TNF-α), and etanercept (Enbrel; Immunex Corporation, Seattle, Washington), a recombinant tumor necrosis factor receptor fusion protein, are new immunomodulating agents used in the treatment of patients with rheumatoid arthritis. Infliximab has also been approved for the management of moderate-to-severe Crohn’s disease. Both agents block the action of TNF-α, a cytokine that has proinflammatory effects and modulates the cellular immune response. Thus, TNF-α inhibition may increase the risk of infection. Postmarketing reports of adverse effects associated with infliximab and etanercept have prompted the Food and Drug Administration (FDA) to announce the risk of serious infections and sepsis associated with the use of these agents. We describe a patient who was treated with infliximab for what was thought to be Crohn’s disease, who became systemically ill with Mycobacterium tuberculosis enteritis.

Crohn's disease: progress confounded.

Editorials1 January 1972Crohn's Disease: Progress ConfoundedALBERT I. MENDELOFF, M.D.ALBERT I. MENDELOFF, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-1-137 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the last 18 months a number of gastroenterologists have made overdue attempts (1-4) to assemble the facts about one of their most puzzling and difficult clinical problems, the peculiar form of inflammatory bowel disease known as regional enteritis or Crohn's disease. For nearly 40 years, this disorder, sometimes presenting acutely but usually insidiously, has become a more and more visible challenge to pathologists, surgeons, and internists. Cases of it were probably buried for many years among the more numerous patients with tuberculosis enteritis; now the rapid decline in prevalence of that entity has left exposed what seems to be...