A Case of Intestinal Tuberculosis Mimicking Crohn’s Disease: A Clinical and Diagnostic Dilemma

This case highlights the importance of differentiating between Crohn’s disease and intestinal tuberculosis. The rates of misdiagnosis of Crohn’s disease and intestinal tuberculosis range from 50% to 70% because of their non-specific and clinically similar manifestations.If intestinal tuberculosis is misdiagnosed as Crohn’s disease, use of immunomodulatory drugs commonly used for Crohn’s disease can increase the risk of disseminated tuberculosis. Here we present a case highlighting the clinical similarity between these two distinct medical conditions and suggest how a similar scenario can be approached, which can help to differentiate between the two otherwise very similar conditions. LEARNING POINTS: Given the similarities, it is key to differentiate Crohn’s disease from intestinal tuberculosis as early as possible. Patients undergoing colonoscopy for possible Crohn’s disease should have colonic biopsy samples sent for AFB culture. Consider investigations for intestinal tuberculosis in uncontrolled Crohn’s disease where intestinal tuberculosis has not been worked up previously.