Diagnostic problem on patient with tuberculous colitis mimicking Crohn’s disease

Abstract

Introduction: Tuberculous colitis and Crohn’s disease (CD) are two disorders that possess similarities in clinical features and colonoscopy findings. Case presentation: The patient had previously undergone colonoscopy and mucosal biopsy in this case report, indicating chronic diarrhea and hematochezia. Based on the results from the colonoscopy, the patient was suspected for Crohn’s disease. Meanwhile, the collected mucosal biopsy stained with Hematoxylin-Eosin suggested the early diagnosis of CD. Hence, patient was prescribed with sulfasalazine 2x500 mg for 6 weeks, where no clinical improvement was found afterward. Patients still complained nausea, vomiting, frequent diarrhea and bloody stools. The patient was later suspected of intestinal tuberculous and prepped for interferon-gamma release assay (IGRA) and stool Xpert MTB/RIF test. Both of the additional tests suggested that the patient was positive tuberculous. According to the collective facts and findings, the patient was diagnosed with intestinal tuberculous and prescribed with category 1 anti-tuberculosis. Conclusion: The patient was followed-up after nine months treated with anti-tuberculosis, where the negative result was obtained from the stool Xpert MTB/RIF test. In the following year after the therapy, the patient felt no complaints.