A 42 years old female was admitted into our hospital on July 2016 complaining of pain in the lower abdomen and watery bloody stool. Colonoscopy showed ischemic change in the descending and sigmoid colon and multiple erosions in the ascending colon. Patient treated as ischemic colitis, and she discharged after conservative therapy for 7 days. After 4 months, colonoscopy showed linear ulcer scar in the descending and sigmoid colon and annular ulcer in the ascending colon. A diagnosis of tuberculosis was made from a biopsy sample taken at the annular ulcer that revealed positive mycobacterium culture results as well as a positive polymerase chain reaction (PCR) assay. Quantiferon (QFT) was also positive. She was placed on four-drug therapy for 6 months.
Following treatment colonoscopy showed no evidence of erosions or ulcers. Findings of erosions in the ileum or ileocecal region suggest tuberculosis, and a high index of suspicion should be maintained when performing diagnostics. Workup should include QFT, which has high sensitivity and specificity and close follow up with colonoscopy should also be done.
