Chen Mei-Ting, Ong Ferdinand, Choy Kay Tai, Chakraborty Joy
Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
Queensland Health, Brisbane, Queensland, Australia.
BMJ Case Rep. 2025 Jan 7;18(1):e262626. doi: 10.1136/bcr-2024-262626.
Colonic tuberculosis (TB) is a rare form of extrapulmonary TB with nonspecific clinical presentations such as weight loss, abdominal pain and fever. It is often misdiagnosed, as the presentations mimic other more common diseases such as colon cancer and inflammatory bowel diseases, especially in those countries with low TB incidence. Although a combination of CT imaging, colonoscopy and histopathology forms the essential part of the diagnostic assessment, the high variability and low specificity of each investigation may delay or overlook the diagnosis. Without treatment, colonic TB could potentially lead to severe malnutrition, bowel obstruction and mortality. We report the case of a man in his 60s presenting with significant weight loss, malnutrition and an abdominal mass for an initial workup of colorectal malignancy. This case highlights the diagnostic pitfall and dynamic management of colonic TB and aims to raise awareness among clinicians to broaden differential diagnoses when encountered with unspecific presentations.
结肠结核是肺外结核的一种罕见形式，临床表现不具特异性，如体重减轻、腹痛和发热。它常常被误诊，因为其表现与其他更常见的疾病相似，如结肠癌和炎症性肠病，尤其是在结核病发病率较低的国家。尽管CT成像、结肠镜检查和组织病理学检查相结合是诊断评估的重要组成部分，但每项检查的高变异性和低特异性可能会延误或漏诊。未经治疗，结肠结核可能会导致严重营养不良、肠梗阻和死亡。我们报告了一例60多岁男性患者的病例，该患者因体重显著减轻、营养不良和腹部肿块前来进行结直肠癌的初步检查。该病例突出了结肠结核的诊断陷阱和动态管理，旨在提高临床医生在遇到非特异性表现时拓宽鉴别诊断的意识。
