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19 Apr 2024 (Vol 47 , Iss 04 )

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30 Apr 2024 (Vol 47 , Iss 04 )

Journal ID : TMJ-02-09-2021-10622
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Title : Problem Diagnostic Patient Tuberculous Colitis Mimicking Crohn’s Disease

Abstract :

Two disorders that present similarly in terms of both clinical features and colonoscopy findings are tuberculous colitis and Crohn’s disease (CD). In this patient had previously colonoscopic and mucosal biopsy with an indication of chronic diarrhea and hematoschezia. Colonoscopic results was suspected CD. The patient also performed a biopsy. Staining of tissue biopsy only with Hematoxylin-Eosin because early diagnosis is CD. After treatment with sulfasalazine 2x500 mg for 6 weeks, there was no clinical improvement. Patients still complain of nausea, vomiting, frequent diarrhea and bloody stools. That's why an alternative diagnosis is thought to be intestinal TB. The patient planned for additional examinations, IGRA test and stool Xpert MTB/RIF. Result of IGRA test is positive and stool Xpert MTB/RIF were low detected and sensitive to rifampicin. Based on clinical data, laboratories and endoscopic results, patient was diagnosed as colonic TB and given category 1 anti tuberculosis treatment. After nine month therapy result of stool Xpert MTB/RIF is not detected. Patient feel no complain until 1 year post therapy.

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