Gastrointestinal tuberculosis: a diagnosis not to miss

Manuel, Ari; Lim, Z.; Wiggins, J

doi:10.4997/jrcpe.2010.305

Cited by 5 publications

(8 citation statements)

References 9 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study confirms that ITB is a disease that predominantly affects younger adults . Most of our patients were from countries with high TB prevalence presenting with abdominal symptoms .…”

Section: Discussionsupporting

confidence: 87%

“…Although this study was carried out retrospectively, it presents one of the largest case series of patients with ITB compared to previous studies conducted in low‐ and high‐incidence countries []. Future large prospective studies are needed to develop diagnostic algorithms that would facilitate early diagnosis and thereby help avoid complications of ITB.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intestinal tuberculosis: a diagnostic challenge

Kentley

Ooi

Potter

et al. 2017

Tropical Med Int Health

View full text Add to dashboard Cite

Abstractobjective To describe characteristics, presentation, time to diagnosis and diagnostic findings of patients with intestinal tuberculosis (ITB) in a low-burden country.method Retrospective study of 61 consecutive ITB patients diagnosed between 2008 and 2014 at a large East London hospital.results Forty of sixty-one patients were male. Mean age was 34.6 years. 93% of patients were born abroad, mostly from TB-endemic areas (Indian subcontinent: 88%, Africa: 9%). 25% had concomitant pulmonary TB. Median time from symptom onset to ITB diagnosis was 13 weeks (IQR 3-26 weeks). Ten patients were initially treated for IBD, although patients had ITB. The main sites of ITB involvement were the ileocaecum (44%) or small bowel (34%). Five patients had isolated perianal disease. Colonoscopy confirmed a diagnosis of ITB in 77% of those performed. 42 of 61 patients had a diagnosis of ITB confirmed on positive histology and/or microbiology.conclusion Diagnosis of ITB is often delayed, which may result in significant morbidity. ITB should be excluded in patients with abdominal complaints who come from TB-endemic areas to establish prompt diagnosis and treatment. Diagnosis is challenging but aided by axial imaging, colonoscopy and tissue biopsy for TB culture and histology.

show abstract

“…Our study confirms that ITB is a disease that predominantly affects younger adults . Most of our patients were from countries with high TB prevalence presenting with abdominal symptoms .…”

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Intestinal tuberculosis: a diagnostic challenge

Kentley

Ooi

Potter

et al. 2017

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…Gastrointestinal TB (GITB) is an important form of extrapulmonary TB (EPTB) and constitutes about 10% of all EPTB cases 7 . Diagnosis of GITB is challenging as the clinical features are protean and overlap with several other infectious and noninfectious diseases 8,9 .…”

Section: Introductionmentioning

confidence: 99%

MTBDRplus and MTBDRsl for simultaneous diagnosis of gastrointestinal tuberculosis and detection of first‐line and second‐line drug resistance

Sharma

et al. 2023

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim: Emergence of drug resistance, especially to second-line drugs, hampers tuberculosis elimination efforts. The present study aimed to evaluate MTBDRplus and MTBDRsl assays for detecting first-line and second-line drug resistance, respectively, in gastrointestinal tuberculosis (GITB). Methods: Thirty ileocecal biopsy specimens, processed in the Department of Microbiology between 2012 and 2022, that showed growth of Mycobacterium tuberculosis on culture were included in the study. DNA, extracted from culture, was subjected to MTBDRplus and MTBDRsl (Hain Lifescience GmbH, Nehren, Germany), following manufacturer's instructions. Their performance was compared against phenotypic drug susceptibility testing (pDST) and gene sequencing. Results: Out of the 30 specimens, 4 (13.33%) were mono-isoniazid resistant, 4 (13.33%) were multidrug resistant (MDR), 2 (6.67%) were pre-extensively drug resistant (pre-XDR), and 2 (6.67%) were mono-fluoroquinolone resistant. The results were 100% concordant with pDST and gene sequencing. Conclusions: In the wake of growing drug resistance in all forms of extrapulmonary tuberculosis, including GITB, MTBDRplus and MTBDRsl are reliable tools for screening of resistance to both first-line and second-line drugs.

show abstract

“…4 The mortality in GITB varies between 8% and 50%, and it has considerable morbidity in the form of intestinal ulcerations, altered bowel habits, and intestinal perforation. 4,5 In fact, GITB is an important cause of small intestinal perforation in India, second only to typhoid. 6 The most important challenge faced in a patient of GITB is the overlapping of symptoms with various other infectious and noninfectious diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Gastrointestinal tuberculosis (GITB) contributes 10% of all extrapulmonary TB (EPTB) cases 4 . The mortality in GITB varies between 8% and 50%, and it has considerable morbidity in the form of intestinal ulcerations, altered bowel habits, and intestinal perforation 4,5 . In fact, GITB is an important cause of small intestinal perforation in India, second only to typhoid 6 .…”

Section: Introductionmentioning

confidence: 99%

Evaluating diagnostic performance of Truenat MTB Plus for gastrointestinal tuberculosis

Sharma

et al. 2022

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim Prompt and accurate diagnosis of gastrointestinal tuberculosis (GITB) along with simultaneous detection of drug resistance is inevitable for tuberculosis elimination. Truenat MTB Plus (TruPlus), a chip‐based real‐time polymerase chain reaction assay, was evaluated for the first time for diagnosing GITB and detecting rifampicin resistance. Methods Fifty ileocecal biopsy specimens (5 microbiologically confirmed GITB [culture‐positive], 25 clinically confirmed GITB [culture‐negative], and 20 control patients) processed in the Department of Microbiology between 2011 and 2021 were subjected to TruPlus assay, Xpert MTB RIF assay multiplex polymerase chain reaction. Their performance was evaluated against both culture and composite reference standard. Results The overall sensitivity and specificity of TruPlus in diagnosing GITB was 70% (21/30) and 100%, respectively. The sensitivity was 60% (3/5) for microbiologically confirmed cases and 72% (18/25) for clinically confirmed cases. Performance of TruPlus was superior to Xpert (sensitivity = 30%; P = 0.001) and comparable with MPCR (sensitivity = 83.33%; P = 0.13). Both TruPlus and MPCR had moderate agreement with reference standards, and MPCR detected additional three cases. Both TruPlus and Xpert correctly reported Rifampicin resistance in three cases. Conclusions TruPlus, with its greater portability and higher sensitivity than Xpert, could serve as an important tool for diagnosing GITB and rifampicin resistance at outreach endemic areas.

show abstract

Gastrointestinal tuberculosis: a diagnosis not to miss

Abstract: Gastrointestinal tuberculosis is not rare but may present to the clinician in a variety of ways, leading to confusion with several other diseases. It is crucial to send tissue samples for culture.

Cited by 5 publications

References 9 publications

Intestinal tuberculosis: a diagnostic challenge

Intestinal tuberculosis: a diagnostic challenge

MTBDRplus and MTBDRsl for simultaneous diagnosis of gastrointestinal tuberculosis and detection of first‐line and second‐line drug resistance

Evaluating diagnostic performance of Truenat MTB Plus for gastrointestinal tuberculosis

Contact Info

Product

Resources

About