Case of intestinal tuberculosis mimicking Crohn’s disease

BACKGROUND: Intestinal tuberculosis can closely mimic Crohn’s disease and colon cancer. Presented here is a case of intestinal tuberculosis that closely mimicked both. CASE REPORT: A 23 year old Hispanic female presented with several months of weight loss, recurrent fever, and emesis. The patient did not have pulmonary symptoms or radiographic evidence of tuberculosis. Colonoscopy evaluation with biopsy of the affected bowel segments were thought to be consistent with either colon cancer or Crohn’s Disease. Acid fast bacilli staining and histological analysis did not display evidence of tuberculosis on two separate occasions. The patient developed colonic obstruction acutely during the course of treatment requiring resection of the affected bowel segment. Acid fast staining of the resected lymph nodes was positive and submucosal caseating granulomas were identified histologically, consistent with intestinal tuberculosis. CONCLUSIONS: Intestinal tuberculosis remains a diagnostic challenge. Consideration of the disease should be maintained in equivocal cases.