Saitou Miwako, Suzuki Tomoko, Niitsuma Katsunao
Kekkaku. 2015 Sep;90(9):631-4.
Intestinal tuberculosis (TB) was recognized as the most common complication with a high frequency of active pulmonary TB during the TB epidemic period. However, intestinal TB has become a rare disease, and intestinal perforation due to intestinal TB is extremely rare. We herein report two cases of tuberculous intestinal perforation.
CASE 1: A 41-year-old man was admitted to our hospital complaining of persistent cough and anorexia. He was in poor nutritional condition, and his body mass index (BMI) and prognostic nutrition index (PNI) were 13.4 and 36.4, respectively. He was diagnosed with pulmonary TB and received anti-TB therapy. On the 51st day of hospitalization, he developed intestinal perforation. Pathologically caseating epithelioid granulomas were noted at the ulcer lesion.
CASE 2: A 61-year-old man was admitted to our hospital due to miliary TB caused by intestinal TB. He had taken oral immunosuppressive drugs and steroids for dermatomyositis over the previous eight years and had a poor nutritional condition, with a BMI of 13.4 and a PNI of 14.4. While receiving anti-TB therapy, he developed intestinal perforation on the 97th day of hospitalization. The patient's poor nutritional condition and immune reconstitution may have contributed to the intestinal perforation.
在结核病流行期间,肠结核被认为是最常见的并发症,同时活动性肺结核的发生率也很高。然而,肠结核已成为一种罕见疾病,因肠结核导致的肠穿孔极为罕见。我们在此报告两例结核性肠穿孔病例。
病例1:一名41岁男性因持续咳嗽和厌食入院。他营养状况较差,体重指数(BMI)和预后营养指数(PNI)分别为13.4和36.4。他被诊断为肺结核并接受抗结核治疗。住院第51天,他发生了肠穿孔。病理检查发现溃疡病变处有干酪样上皮样肉芽肿。
病例2:一名61岁男性因肠结核引起的粟粒性结核入院。在过去八年中,他因皮肌炎服用口服免疫抑制药物和类固醇,营养状况较差,BMI为13.4,PNI为14.4。在接受抗结核治疗期间,他于住院第97天发生了肠穿孔。患者营养状况差和免疫重建可能是导致肠穿孔的原因。