PDF(Pubmed)
Abstract：
Diagnosing intestinal tuberculosis (TB) with uncommon clinical manifestations is often challenging. Here, we report a case of an alcoholic patient who presented with vague symptoms and was later diagnosed with intestinal TB. This patient experienced multiorgan failure causing hemodynamic instability requiring ionotropic support; acute hypoxic respiratory failure managed with non-invasive positive pressure ventilation, hepatic failure, transudative peritoneal effusion, and transudative pleural effusion. These conditions clouded our judgment to pursue colonoscopy for a definite diagnosis and delayed the anti-tuberculosis treatment. When intestinal tuberculosis TB is suspected, the differential diagnosis must be established with other gastrointestinal involving diseases, including mycobacterium avium complex (MAC) and Crohn\'s disease (CD). MAC can show overlapping features with intestinal TB or coexist with it; Acid-fast stain and tissue culture are the key tests to differentiate these two. In the presence of diagnostic uncertainty between intestinal TB and CD, a therapeutic trial with anti-tuberculous therapy may be warranted.
摘要：
诊断具有罕见临床表现的肠结核（TB）通常具有挑战性。这里,我们报道了一例酒精中毒患者,症状模糊,后来被诊断为肠道结核.该患者出现多器官功能衰竭，导致血流动力学不稳定，需要离子型支持；急性低氧性呼吸衰竭采用无创正压通气治疗，肝衰竭,渗出性腹膜积液,和渗出性胸腔积液。这些情况掩盖了我们进行结肠镜检查以明确诊断的判断，并推迟了抗结核治疗。当怀疑肠结核时，必须与其他涉及胃肠道的疾病建立鉴别诊断，包括鸟分枝杆菌复合体（MAC）和克罗恩病（CD）。MAC可以与肠道TB表现出重叠或共存的特征；耐酸染色和组织培养是区分这两者的关键测试。在肠道结核和CD之间存在诊断不确定性的情况下，可能需要进行抗结核治疗的治疗试验.
