Intestinal tuberculosis diagnosed by clinical presentation, imaging, and endoscopy, associated with pulmonary tuberculosis: A case report and narrative literature review

Objective

Intestinal tuberculosis (ITB) represents an atypical clinical manifestation of tuberculosis, constituting a significant proportion of extrapulmonary cases. This study, combining a case report and a narrative literature review, aims to deepen the understanding of ITB and its clinical characteristics.

Case presentation

We present a clinical case of a young patient with concomitant pulmonary tuberculosis and chronic gastrointestinal symptoms. Imaging studies revealed intestinal wall thickening in the ileum and cecum, findings corroborated by colonoscopy, which showed multiple ulcers and an inflammatory response on biopsy, albeit without direct identification of the bacillus. The patient responded favorably to standard anti-tuberculosis treatment.

Discussion

Our findings, coupled with the literature review, suggest that ITB can present with nonspecific clinical features, hindering early diagnosis. Coexistence with pulmonary tuberculosis is common, and complications such as intestinal obstruction may necessitate surgical intervention.

Conclusion

Intestinal tuberculosis poses a diagnostic challenge due to the variability of its clinical manifestations and the lack of specific diagnostic tests. A high index of clinical suspicion, particularly in patients with pulmonary tuberculosis or risk factors, is crucial for early diagnosis, appropriate management, and consequently enhance the prognosis of the disease.