Diagnostic challenges of intestinal tuberculosis in a patient with chronic diarrhoea: Case report

Abstract

A case of intestinal tuberculosis affecting the jejunum (with perforations) and the colon is presented. The objective is to highlight the challenges medical practitioners face in making a timely diagnosis of intestinal tuberculosis. It also aims to raise awareness that chronic diarrhoea and weight loss are common symptoms of colonic tuberculosis. A 26 year old university student was admitted with a three month history of diarrhoea anorexia and weight loss having been seen and treated for typhoid in several hospitals without improvement. Colonoscopy and biopsy was non conclusive. He later developed subacute intestinal obstruction that did not respond to conservative treatment. Explorative laparotomy revealed jejunal perforations with localised absesses, peritoneal adhesions with caseous nodules and mesenteric Iymphadenopathy. Histology of resected specimens was positive for mycobacterium tuberculosis.