Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature
Introduction: Intestinal tuberculosis (ITB), a rare yet severe manifestation of Mycobacterium tuberculosis infection, poses significant diagnostic and therapeutic challenges due to its nonspecific clinical presentation. Perforation, a life-threatening complication, necessitates prompt surgical inter...
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Elsevier
2024-10-01
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| author | Imen Ben Ismail Saber Rebii Mlika Mouna Marwen Sghaier Khadija Yaich Ayoub Zoghlami |
| author_facet | Imen Ben Ismail Saber Rebii Mlika Mouna Marwen Sghaier Khadija Yaich Ayoub Zoghlami |
| author_sort | Imen Ben Ismail |
| collection | DOAJ |
| description | Introduction: Intestinal tuberculosis (ITB), a rare yet severe manifestation of Mycobacterium tuberculosis infection, poses significant diagnostic and therapeutic challenges due to its nonspecific clinical presentation. Perforation, a life-threatening complication, necessitates prompt surgical intervention and effective antituberculous therapy. Case presentation: This case study highlights a 41-year-old immunocompetent male who presented with fever, abdominal pain, vomiting, and significant weight loss. A computed tomography scan revealed minimal pneumoperitoneum, intestinal wall thickening, mesenteric fat stranding, lymphadenopathy, and an intra-abdominal abscess. Exploratory laparotomy identified a perforation at the terminal ileum, leading to ileocaecal resection and stoma formation. Histopathological examination confirmed ITB, and a nine-month regimen of antituberculous medication was initiated. Discussion: ITB, more common in immunocompromised individuals, can also affect immunocompetent patients, often mimicking other gastrointestinal conditions and delaying diagnosis. This case underscores the importance of considering ITB in differential diagnoses for patients with vague gastrointestinal symptoms. Diagnostic confirmation typically requires a combination of clinical, radiological, and microbiological assessments, with histopathology playing a crucial role. Factors such as age and comorbidities can increase the risk of severe complications like perforation. Surgical resection with anastomosis tends to yield better outcomes than direct closure, and comprehensive antituberculous therapy is essential for successful treatment. Conclusion: The complexity of diagnosing and managing ITB, compounded by its severe complications, necessitates heightened awareness among healthcare providers. Accurate diagnosis, timely surgical intervention, and rigorous antituberculous therapy are vital for improving patient outcomes, especially in high-risk populations or regions with prevalent TB. |
| format | Article |
| id | doaj-art-751f2a845b084051932f8d56d444eebd |
| institution | OA Journals |
| issn | 2405-8440 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-751f2a845b084051932f8d56d444eebd2025-08-20T02:14:03ZengElsevierHeliyon2405-84402024-10-011020e3909610.1016/j.heliyon.2024.e39096Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literatureImen Ben Ismail0Saber Rebii1Mlika Mouna2Marwen Sghaier3Khadija Yaich4Ayoub Zoghlami5University of Tunis El Manar Faculty of Medicine of Tunis, Department of General Surgery, Trauma Center Ben Arous, Tunisia; Corresponding author.University of Tunis El Manar Faculty of Medicine of Tunis, Department of General Surgery, Trauma Center Ben Arous, TunisiaUniversity of Tunis El Manar Faculty of Medicine of Tunis, Department of Pathology, Trauma Center Ben Arous, TunisiaUniversity of Tunis El Manar Faculty of Medicine of Tunis, Department of General Surgery, Trauma Center Ben Arous, TunisiaUniversity of Tunis El Manar Faculty of Medicine of Tunis, Department of General Surgery, Trauma Center Ben Arous, TunisiaUniversity of Tunis El Manar Faculty of Medicine of Tunis, Department of General Surgery, Trauma Center Ben Arous, TunisiaIntroduction: Intestinal tuberculosis (ITB), a rare yet severe manifestation of Mycobacterium tuberculosis infection, poses significant diagnostic and therapeutic challenges due to its nonspecific clinical presentation. Perforation, a life-threatening complication, necessitates prompt surgical intervention and effective antituberculous therapy. Case presentation: This case study highlights a 41-year-old immunocompetent male who presented with fever, abdominal pain, vomiting, and significant weight loss. A computed tomography scan revealed minimal pneumoperitoneum, intestinal wall thickening, mesenteric fat stranding, lymphadenopathy, and an intra-abdominal abscess. Exploratory laparotomy identified a perforation at the terminal ileum, leading to ileocaecal resection and stoma formation. Histopathological examination confirmed ITB, and a nine-month regimen of antituberculous medication was initiated. Discussion: ITB, more common in immunocompromised individuals, can also affect immunocompetent patients, often mimicking other gastrointestinal conditions and delaying diagnosis. This case underscores the importance of considering ITB in differential diagnoses for patients with vague gastrointestinal symptoms. Diagnostic confirmation typically requires a combination of clinical, radiological, and microbiological assessments, with histopathology playing a crucial role. Factors such as age and comorbidities can increase the risk of severe complications like perforation. Surgical resection with anastomosis tends to yield better outcomes than direct closure, and comprehensive antituberculous therapy is essential for successful treatment. Conclusion: The complexity of diagnosing and managing ITB, compounded by its severe complications, necessitates heightened awareness among healthcare providers. Accurate diagnosis, timely surgical intervention, and rigorous antituberculous therapy are vital for improving patient outcomes, especially in high-risk populations or regions with prevalent TB.http://www.sciencedirect.com/science/article/pii/S2405844024151274Intestinal tuberculosisMycobacterium tuberculosisPerforationAbdominal tuberculosis |
| spellingShingle | Imen Ben Ismail Saber Rebii Mlika Mouna Marwen Sghaier Khadija Yaich Ayoub Zoghlami Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature Heliyon Intestinal tuberculosis Mycobacterium tuberculosis Perforation Abdominal tuberculosis |
| title | Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature |
| title_full | Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature |
| title_fullStr | Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature |
| title_full_unstemmed | Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature |
| title_short | Intestinal tuberculosis complicated with perforation in an immunocompetent patient: Case report and review of the literature |
| title_sort | intestinal tuberculosis complicated with perforation in an immunocompetent patient case report and review of the literature |
| topic | Intestinal tuberculosis Mycobacterium tuberculosis Perforation Abdominal tuberculosis |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024151274 |
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