Zusammenfassung
Die Differenzialdiagnose granulomatöser Darmerkrankungen führt wiederholt zu Fehldiagnosen. Unser Patient, der sich mit gastrointestinalen Beschwerden vorstellte, wurde aufgrund des zunächst diagnostizierten M. Crohn immunsuppressiv behandelt. Unter der Therapie exazerbierten jedoch die Symptome. Der Nachweis von säurefesten Stäbchen in verschiedenen Körpersekreten und die Präsenz nekrotisierender Granulome in Darmbiopsien führten zur Diagnose einer Abdominaltuberkulose. Unter einer adäquaten tuberkulostatischen Therapie verbesserte sich der Zustand des Patienten.
Abstract
The differential diagnosis of granulomatous intestinal diseases leads to recurrent false diagnoses. Our patient who was presenting with gastrointestinal complaints was first diagnosed as having Crohn’s disease. Put on an immunosuppressive treatment, the symptoms deteriorated. Examination of sputum revealed acid-fast bacilli, later confirmed as M. tuberculosis in culture, and colonoscopy showed necrotizing granulomas, which lead us to the final diagnosis of abdominal tuberculosis. Our patient improved under an adequate tuberculostatic regime.
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Hofer, A., Schmiedel, S., Lohse, A. et al. Therapierefraktäre schwere Ileokolitis. Internist 49, 1115–1119 (2008). https://doi.org/10.1007/s00108-008-2098-8
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DOI: https://doi.org/10.1007/s00108-008-2098-8