AI Article Synopsis
- * Imaging indicated complications including pneumonia and a pelvic abscess, with a subsequent diagnosis of disseminated tuberculosis affecting the digestive system; TB treatment was initiated, and immunosuppressive therapy stopped.
- * Despite initial respiratory improvement, surgical intervention was necessary due to severe ileal complications; pathology confirmed the presence of both Crohn's disease and intestinal tuberculosis, but her recovery post-surgery was smooth.
Article Abstract
A woman in her 20s with a recent diagnosis of Crohn's disease (CD) affecting the ileocaecal valve was started on adalimumab, after routine tuberculosis (TB) tests were negative. Her abdominal symptoms got worse and she started presenting respiratory distress and fever. Tomography revealed a left pleural effusion, pneumonia and peritonitis with pelvic abscess. The diagnosis of disseminated TB with digestive involvement was suggested and sputum cultures were positive for Treatment for TB was started and immunosuppressants discontinued, leading to respiratory improvement. Abdominal imaging was repeated, showing worsening signs of multisegmental ileal wall thickening, ileocaecal valve obstruction and a persistent pelvic abscess. She was then submitted to a laparoscopic ileocaecal resection for suspicion of worsening CD. Histopathology showed chronic ileocolitis compatible with CD and ganglionic tuberculosis, revealing the diagnosis of intestinal tuberculosis superimposed in CD. Recovery was uneventful.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729158 | PMC |
| http://dx.doi.org/10.1136/bcr-2022-254400 | DOI Listing |
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