# Beyond the Lungs: A Rare Encounter With Tuberculous Colitis in the Colon

## TL;DR

This paper presents a rare case of intestinal tuberculosis in a 27-year-old woman, highlighting the difficulty in diagnosing this condition due to its nonspecific symptoms.

## Contribution

The novelty lies in reporting a rare manifestation of tuberculosis in the colon and emphasizing diagnostic challenges.

## Key findings

- The patient showed colonic wall thickening and granulomatous colitis consistent with intestinal tuberculosis.
- Symptoms improved with antituberculosis treatment, confirming the diagnosis.
- The case highlights the importance of considering TB in differential diagnoses of unexplained colitis.

## Abstract

Intestinal tuberculosis is a very rare manifestation of bacterial tuberculosis. Affected patients often present with nonspecific symptoms which could mimic Crohn’s disease, intestinal cancer, or amebiasis. Consequently, the presentation of intestinal tuberculosis remains a diagnostic challenge. Here, we report the case of a 27-year-old female with a past medical history of external hemorrhoids who presents to the hospital with complaints of generalized weakness, dizziness, watery diarrhea, significant weight loss, and near syncope. CT abdomen and pelvis with oral contrast revealed colonic wall thickening suggestive of colitis as well as bibasilar reticulonodular opacities and left basilar cavitary lesions concerning for infection with suspicion for mycobacterial organisms. AFB smear was positive for TB. Colonoscopy revealed some ulcers, which were biopsied. Results of the biopsy revealed diffuse granulomatous colitis in the cecum and active granulomatous colitis in the ascending and descending colon. The patient was eventually diagnosed with ITB colitis. Her symptoms improved with antituberculosis medications.