Abstract
Introduction: In recent years, the incidence of intestinal tuberculosis has been increasing. This is, in part, due to the pandemic of HIV. Intestinal tuberculosis can be difficult to diagnose and needs a high index of suspicion. The aim of our study is to describe epidemiological, clinical and therapeutic aspects of intestinal tuberculosis in Tunisian adults.
Material and methods: Retrospective study of all intestinal tuberculosis recorded from January 1996 to December 2007 in gastroenterology B department of Rabta Hospital in Tunis.
Results: Eleven patients were included: five males and six females. Mean age was 35. Clinical manifestations were dominated by abdominal pain. Biologic signs of inflammation were constant. The intradermal tuberculin reaction was positive in 27% of the cases. Mycobacterium tuberculosiswas identified in sputum or urine in two patients. HIV serology was negative in all cases. Lesions were more frequently localized in the ileo-caecal area (36%). Ulcerations were present in 72% of the cases. In histology reports, a granuloma with caseating necrosis was present in three cases (27%). M. tuberculosiswas isolated on ileo-colonic biopsies in three patients (27%). Morphologic studies showed ileo-caecal valve or ileal stenosis in six patients (54.5%). Extraintestinal tuberculosis was associated in 45% of the cases. Antituberculous therapy was given in seven patients for a mean duration of nine months (four patients were lost). Clinical and endoscopic outcome was favourable in 86% of the cases.
Conclusion: Although Tunisia is a high endemic country for tuberculosis, intestinal tuberculosis is rare. However, it should be suspected mainly in patient having history of tuberculosis or in case of characteristic clinical or radiological signs.