DOI: 10.1128/asmcr.00105-24 ISSN: 2996-2684

Histopathologic and molecular diagnosis of gastrointestinal tuberculosis in an immunocompetent patient: case report

Sashank Cherukuri, Emily B. Huang, Arthur H. Totten, Jonathan Steinberg, Sunjida Ahmed
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ABSTRACT

Background

Gastrointestinal tuberculosis (GI TB) is an extrapulmonary manifestation of infection with the bacterium Mycobacterium tuberculosis . While GI TB was once considered a rare entity, it has increasing prevalence with the use of immunosuppressive treatments. Diagnosis can be challenging as GI TB can be misdiagnosed as other primary etiologies.

Case Summary

Here, we present a case of GI TB in which the patient was immunocompetent and presented with nonspecific symptoms, and an interferon-gamma release assay, which was positive. Subsequent biopsies were performed of the ascending colon, all showing positivity on acid-fast bacilli (AFB, Ziehl-Neelsen) and Fite stains, along with non-caseating granulomas on histopathologic review.

Conclusion

In the presented case, the patient is immunocompetent. GI TB was diagnosed after histopathologic examination of colonic biopsies. This highlights the importance of having a high index of suspicion for unusual presentations of tuberculosis, especially in patients who come from endemic areas or who might have been exposed recently.

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