Back to Search
Start Over
Experience with two cases of intestinal tuberculosis: utility of the QuantiFERON-TB Gold test for diagnosis
- Source :
- Surgical infections. 9(3)
- Publication Year :
- 2008
-
Abstract
- Intestinal tuberculosis is rare in Western countries, with incidence rates of 35.7 and 0.43 per 100,000 per year for the immigrant and native populations, respectively. Despite a clear increase in the frequency of extrapulmonary tuberculosis in immunosuppressed patients, the clinical features of intestinal tuberculosis are seen rarely. A typical clinical presentation includes abdominal pain, weight loss, fever, weakness, nausea, vomiting, obstruction, and bleeding. Intestinal tuberculosis often mimics inflammatory bowel disease or malignant neoplasia, and its preoperative diagnosis is a challenge. Microbiologic diagnosis often is difficult because the causative microorganism requires a long incubation period.Two case reports and review of the pertinent literature.We report two cases of colonic tuberculosis mimicking cecal carcinoma in one patient and periappendiceal abscess in the other. A 75 year-old man underwent right hemicolectomy for a right colon mass. Preoperative laboratory, radiologic, and endoscopic evaluations were negative for tuberculosis and carcinoma. The QuantiFERON-TB Gold test was positive. Surgical specimen histologic review showed non-caseating granulomas and rare Ziehl-Neelsen-positive bacilli. A 35 year-old man, born in Sri Lanka but living in Italy for 10 years, came to our attention for a periappendiceal abscess. Multiple peritoneal micro-nodules were found at laparotomy. Their extemporaneous histologic examination showed granulomas and giant-cell inflammation. A right hemicolectomy was performed. The QuantiFERON-TB Gold test, performed on peritoneal fluid and blood, was positive in both.The QuantiFERON-TB Gold test may hold promise for use in intestinal inflammatory diseases when tuberculosis is suspected but conventional workup is not diagnostic.
- Subjects :
- Microbiology (medical)
Adult
Male
medicine.medical_specialty
Abdominal pain
Weakness
Tuberculosis
Nausea
Colon
Gastroenterology
Inflammatory bowel disease
Interferon-gamma
Colon surgery
Internal medicine
medicine
Ascitic Fluid
Humans
Abscess
Aged
Inflammation
business.industry
Mycobacterium tuberculosis
medicine.disease
Surgery
Infectious Diseases
Blood
Tuberculosis, Gastrointestinal
Vomiting
Reagent Kits, Diagnostic
medicine.symptom
business
Subjects
Details
- ISSN :
- 10962964
- Volume :
- 9
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Surgical infections
- Accession number :
- edsair.doi.dedup.....2094d64eadd739c21d423d610edd1b8d