Concomitant lung and intestinal tuberculosis - case report

Vol. 60 No. 2, 2019

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Floarea Mimi Nitu, Cristina Calarasu, Roxana Maria Nemes, Letitia Adela-Maria Streba, Alexandra Floriana Nemes, Madalina Olteanu, Andreea-Loredana Golli

Tuberculosis (TB) is responsible for one in five deaths for young women (between 15-44 years old). Almost 9 million persons are diagnosed with TB each year and around 2 million deaths are due to TB or TB complications. Abdominal TB has no specific clinical symptoms, no imagistic and no specific laboratory tests, all these making the diagnosis more difficult. Most often, clinical, radiographic, and histopathological (HP) aspects in TB enteritis are nonspecific and may suggest cancer or inflammatory bowel disease. We present the case of a 42-year-old male patient, with intestinal and lung TB presenting as intestinal obstruction to emphasize the importance of clinical suspicion and histopathology for final diagnosis. Chest and abdomen computed tomography (CT) evidenced a few left-sided pulmonary nodules and wall thickening of some parts of the small and large bowel. Also, CT evidenced nearby mesenteric lymphadenopathy. He was admitted in the Department of Surgery and later confirmed with intestinal TB. Because of modified chest radiography, further investigations identified Mycobacterium tuberculosis in the sputum. Final diagnosis was concomitant lung and intestinal TB confirmed by sputum and histopathology. The patient received proper anti-tuberculous treatment and his condition improved after the first month. The physician treating the organ is the one that should establish the diagnosis of extra-respiratory TB; however, treatment and later follow-up are multidisciplinary. TB should always be suspected in any patient with nonspecific symptoms. The TB case is defined according to disease localization, bacteriological or HP confirmation, therapeutic history and human immunodeficiency (HIV) infection status.

Corresponding author: Madalina Olteanu, Lecturer, MD, PhD; e-mail: m03olteanu@yahoo.com

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