A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl

Ga Young Park; Jae Young Park; Chang Hwi Kim; Jeong Ja Kwak; Jae Ock Park

doi:10.14776/kjpid.2013.20.3.190

Journal List > Korean J Pediatr Infect Dis > v.20(3) > 1096044

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Park, Park, Kim, Kwak, and Park: A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl

Case Report

Korean Journal of Pediatric Infectious Diseases 2013; 20(3): 190-196.

Published online: 26 December 2013

DOI: https://doi.org/10.14776/kjpid.2013.20.3.190

A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl

Ga Young Park, M.D., Jae Young Park, M.D., Chang Hwi Kim, M.D., Jeong Ja Kwak, M.D.^*, Jae Ock Park, M.D.

Department of Pediatrics, Soonchunhyang University College of Medicine, Bucheon, Kyonggido, Korea.

^*Department of Pathology, Soonchunhyang University College of Medicine, Bucheon, Kyonggido, Korea.

Corresponding author (jop50@schmc.ac.kr)

Received 16 May 2013 Revised 16 September 2013 Accepted 4 September 2013

Abstract

Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.

Keywords: Tuberculous enteritis, Pulmonary tuberculosis

Figures and Tables

Fig. 1

Chest PA film shows ill-defined nodules and linear opacity in both upper and left lower lung field with pleural thickening in left pleural space.

Fig. 2

Double-contrast small bowel study shows multiple nodular defects with absence of normal mucosal folds involving cecum and ascending colon.

Fig. 3

Colonoscopy shows multiple ulcers with exudation and pseudopolyps from transverse colon to ascending colon and ileocecal valve.

Fig. 4

Histological examination of the colonic biopsy specimen shows active ulcer with severe infiltration of acute and chronic inflammatory cells (Hematoxylin-Eosin stain, ×40) (A), and an ill-defined epitheloid granuloma (H-E stain, ×100) (B).

Fig. 5

The result of PCR for Mycobacterium tuberculosis from the specimen through colonoscopic biopsy is positive. Lane 1: DNA marker, Lane 2: negative control, Lane 3: positive control, Lane 5: patient's sample.

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