A CASE OF COLONIC TUBERCULOSIS WITH VERIFIED MYCOBACTERIUM TUBERCULOSIS BY COLONOSCOPIC BIOPSY

Abstract

A 60-year-old man was admitted to our hospital because of general fatigue and diarrhea. Chest X-ray film revealed diffuse interstitial infiltrates with calcification in both upper lung fields, and bacteriological examination of the sputum showed acid fast bacilli. Those laboratory findings suggested active pulmonary tuberculosis. Barium enema showed circular strictures with irregular wall in the descending and transverse colons. Colonoscopy revealed shallow ulcers with edematous hemorrhagic border and circular strictures in the descending colon, which suggested active colonic tuberculosis. Colono-scopic biopsy was performed and acidfast bacilli were found in the biopsied specimen by Ziehl-Neelsen stain. Making the definite diagnosis of colon tuberculosis by colonoscopic biopsy is not easy and the confirmation of Mycobacterium tuberculosis has been rarely successful. This is the 6th reported Japanese case in which Mycobacterium tuberculosis was verified by colono-scopic biopsy.