Crohn's Disease or Intestinal Tuberculosis. A Diagnostic Challenge.

Crohn's disease and intestinal tuberculosis (TB) share many clinical, radiological and endoscopic features. A definitive diagnosis in these cases is extremely important, to avoid the toxicity of unnecessary antituberculous therapy in patients with Crohn's disease and potentially fatal immunosuppressive treatment in patients with intestinal TB. A 42-year-old male presented with weight loss, recurrent fever, diarrhea, right iliac fossa pain, night sweats for several months. Abdominal ultrasonography with ileo-cecal wall thickening and retroperitoneal adenopathies and colonoscopy evaluation were thought to be consistent with Crohn's disease. However, the diagnosis was disseminated tuberculosis with lung and colon involvement based on the diffuse, bilateral small nodules seen on Chest X-ray and tuberculoid granulomas revealed on the colon biopsies. [ABSTRACT FROM AUTHOR]