Intestinal Tuberculosis Presenting with Gastrointestinal Bleeding in Patient on Warfarin Therapy

Background Intestinal tuberculosis (ITB) constitutes less than 5% of overall cases of extrapulmonary disease and mostly affects the ileocecal region. The presentation and radiologic findings in enteric tuberculosis can mimic Crohn's disease (CD). Case Presentation. We present a case report of an African woman who presented to a Kenyan hospital with lower gastrointestinal bleeding while on anticoagulation for valvular atrial fibrillation, and was diagnosed with intestinal tuberculosis after colonoscopy, biopsy, and positive staining for tuberculous bacilli. Conclusion Intestinal tuberculosis causing gastrointestinal bleeding is rare but should be suspected in patients living in TB endemic regions.

[1]  F. Youssef,et al.  Intestinal Tuberculosis Masquerading as Crohn's Disease? A Case of Disseminated Tuberculosis after Anti-TNF Therapy for Suspected Crohn's Disease , 2019, Case reports in gastrointestinal medicine.

[2]  G. Kaplan,et al.  Evolving Epidemiology of IBD , 2019, Current Gastroenterology Reports.

[3]  Qingli Zhu,et al.  The potential role of CT enterography and gastrointestinal ultrasound in the evaluation of anti-tubercular therapy response of intestinal tuberculosis: a retrospective study , 2019, BMC Gastroenterology.

[4]  P. Sahni,et al.  Differentiating Crohn’s disease from intestinal tuberculosis , 2019, World journal of gastroenterology.

[5]  P. Klatser,et al.  Extra-pulmonary tuberculosis: A retrospective study of patients in Accra, Ghana , 2019, PloS one.

[6]  M. Ezekowitz,et al.  Locations and Mucosal Lesions Responsible for Major Gastrointestinal Bleeding in Patients on Warfarin or Dabigatran , 2018, Digestive Diseases and Sciences.

[7]  N. Sengupta,et al.  Resumption of Warfarin After Hospitalization for Lower Gastrointestinal Bleeding and Mortality Benefits , 2017, Journal of clinical gastroenterology.

[8]  Simon Tiberi,et al.  Intestinal tuberculosis: a diagnostic challenge , 2017, Tropical medicine & international health : TM & IH.

[9]  M. Scalese,et al.  Management of Oral Anticoagulation Therapy After Gastrointestinal Bleeding: Whether to, When to, and How to Restart an Anticoagulation Therapy , 2017, The Annals of pharmacotherapy.

[10]  Rohini Sharma,et al.  Evaluation of Xpert MTB/RIF assay performance in the diagnosis of abdominal tuberculosis , 2017, Intestinal research.

[11]  P. Higgins,et al.  Meta-Analytic Bayesian Model For Differentiating Intestinal Tuberculosis from Crohn's Disease , 2017, The American Journal of Gastroenterology.

[12]  Xiaoqing Liu,et al.  Clinical and Laboratory Diagnosis of Intestinal Tuberculosis , 2016, Chinese medical journal.

[13]  Raju Sharma,et al.  Intestinal tuberculosis versus crohn's disease: Clinical and radiological recommendations , 2016, Indian Journal of Radiology and Imaging.

[14]  W. Coyle,et al.  Gastrointestinal Tuberculosis , 2016, Microbiology spectrum.

[15]  M. Ramírez-Lapausa,et al.  [Extrapulmonary tuberculosis]. , 2015, Revista espanola de sanidad penitenciaria.

[16]  U. Debi,et al.  Abdominal tuberculosis of the gastrointestinal tract: revisited. , 2014, World journal of gastroenterology.

[17]  L. Gabbasova,et al.  Global tuberculosis report (2014) , 2014 .

[18]  Jin-Ho Kim,et al.  Prospective Randomized Trial of Six-Month versus Nine-Month Therapy for Intestinal Tuberculosis , 2009, Antimicrobial Agents and Chemotherapy.

[19]  Erkan Ceylan,et al.  Clinical presentation of abdominal tuberculosis in HIV seronegative adults , 2005, BMC gastroenterology.

[20]  M. Tzardi,et al.  Colonic tuberculosis mimicking Crohn's disease: case report , 2002, BMC gastroenterology.

[21]  H. Ha,et al.  Intestinal tuberculosis with abdominal complications: radiologic and pathologic features , 1999, Abdominal Imaging.

[22]  C. Dolea,et al.  World Health Organization , 1949, International Organization.