Pathology of intestinal tuberculosis and its distinction from Crohn's disease

Hd, Tandon; Prakash, Apurva

doi:10.1136/gut.13.4.260

Cited by 228 publications

(177 citation statements)

References 29 publications

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“…Culture of acid‐fast bacilli (AFB) is the gold standard for a positive diagnosis of ITB 7, 8, 9. However, a positive yield of Mycobacterium tuberculosis (MTB) complex is obtained in only 25–50% of cases on culture of intestinal biopsy tissue,4, 7, 8, 9 making it difficult to test for drug resistance.…”

Section: Introductionmentioning

confidence: 99%

Drug resistance in intestinal tuberculosis: A reason to worry?

et al. 2017

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Background and AimEmergence of drug resistance in intestinal tuberculosis (ITB) makes the treatment of this condition challenging. While there is growing evidence of multiple and extensive drug resistance in pulmonary and glandular tuberculosis (TB), literature regarding susceptibility and resistance patterns in ITB is scarce. The aim of the current paper was to study the prevalence of drug resistance in patients with ITB.MethodsAmong patients presenting to a tertiary care hospital in Mumbai between 2008 and 2016, records of all patients with ITB, whose mucosal biopsy (obtained at ileocolonoscopy) tissue culture was positive for Mycobacterium tuberculosis and in whom drug sensitivity testing was performed, were retrospectively analyzed. Sensitivity and resistance to single or multiple anti‐TB drugs were noted.ResultsA total of 43 patients were included, of whom 10 (23.2%) patients were diagnosed to have resistance to at least one first‐line anti‐TB drug. Resistance to isoniazid was the most common (nine patients), followed by rifampicin (six), pyrazinamide (five), streptomycin and ethionamide (four each), ethambutol, moxifloxacin and ofloxacin (three each), and p‐amino salicylic acid (one). Six patients (13.9%) had multidrug‐resistant TB and needed second‐line anti‐TB therapy as per drug sensitivity pattern. There was no patient with extensive drug‐resistant TB.ConclusionTwenty‐three percent of our patients with ITB tested for drug resistance had drug resistance, 13.9% being multidrug resistant and needing second‐line anti‐TB therapy.

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Section: Introductionmentioning

confidence: 99%

Drug resistance in intestinal tuberculosis: A reason to worry?

et al. 2017

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“…In the study conducted by Muhammad Saleem Shaikh SM Sisodia , Tandon HD, Anil Kumar, Veerabhadrarao Rao , reported that the majority of the patients were of age group between 20-40 yrs. [5][6][7][8][9] We observed that there is slight male preponderance with Male:Female ratio of 1.4:1, in the study conducted by Chalya PL. Male:female ratio was (1.4:1), in study by Urabinohatti KA ratio was 1.8:1, Awasthi S also reported ratio of 1.4:1, and male preponderance was the finding in most of the studies.…”

Section: Discussionmentioning

confidence: 84%

Surgical interventions in abdominal tuberculosis: a clinico-pathological study

2017

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Background: Abdominal tuberculosis is a common site for extrapulmonary TB, which affects young population and poses a big diagnostic and therapeutic challenge. Methods: A total 100 cases suspicious of abdominal tuberculosis undergoing surgical interventions were studied in the present study in our institute for period of 18 Months. Results: Males belonging to young age group of 21-40 were most commonly affected. Primary abdominal tuberculosis was the most common etiopathological cause. Abdominal pain seen in 86% of patients. Abdominal tenderness seen in 84% of patients. The condition was more common in people of low socioeconomic status. Primary abdominal tuberculosis was more common than cases secondary to pulmonary TB. Majority of patients had abdominal pain and distention at the time of presentation. Bowel adhesions was the most common intra operative finding followed by stricture, mesenteric lymphadenopathy and bowel perforations. Majority of biopsies show granulomatous lesions. Exploratory laprotomy with adhesiolysis was the most common single procedure performed multiple procedures with covering ileostomy resulted in better survival, lower serious post-operative complication rate and shorter duration of hospital stay. Conclusions: Young males are most commonly affected usually presents with abdominal pain. Bowel adhesions and strictures were most common intraoperative finding, an ileostomy in selected cases found to be result in significant reduction in morbidity and mortality in cases of abdominal tuberculosis undergoing surgery.

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“…In 4 cases where there was no caseating granuloma in the resected sample, the diagnosis was based on both macro scopic and histologic findings of the resected samples, such as the presence of noncaseating granulomas with confluent tendency and the lack of fissuring and edema microscopically as well as the presence of transverse ulcerations with scarring macroscopically, as described by Tandon and Prakash (1972). In another 16 cases, which were treated non-surgically, the diagnosis was made on the basis of both the demonstration of noncaseating granulomas in biopsied tissue and therapeutic differential diagnosis with anti-tubercular therapy, in addition to the clinical features, x-ray findings and endoscopic findings.…”

Section: Methodsmentioning

confidence: 99%