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Case Reports in Gastrointestinal Medicine
Volume 2017, Article ID 7831907, 5 pages
https://doi.org/10.1155/2017/7831907
Case Report

Hematochezia: An Uncommon Presentation of Colonic Tuberculosis

1Department of Medicine, University of Florida, Gainesville, FL 32608, USA
2Department of Medicine, Division of Gastroenterology, University of Florida, Gainesville, FL 32608, USA
3Department of Medicine, Division of Infectious Disease, University of Florida, Gainesville, FL 32608, USA

Correspondence should be addressed to Fares Ayoub; ude.lfu.enicidem@buoya.seraf

Received 16 February 2017; Accepted 28 March 2017; Published 3 April 2017

Academic Editor: Tetsuo Hirata

Copyright © 2017 Fares Ayoub et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abdominal tuberculosis (TB) is an uncommon entity in the United States. Colonic TB is reported in 2-3% of patients with abdominal TB. It is frequently misdiagnosed as Crohn’s disease or carcinoma of the colon due to their shared clinical, radiographic, and endoscopic presentations. We present a case of a 72-year-old male with colonic tuberculosis presenting as hematochezia. Our patient presented with shortness of breath and weight loss. Chest X-ray demonstrated ill-defined bilateral parenchymal opacities in the perihilar, mid, and lower lung zones. The patient was diagnosed and treated for community acquired pneumonia, with no improvement. Hematochezia complicated by symptomatic hypotension developed later in the course of admission. Colonoscopy revealed multiple ulcers at the anus and transverse and ascending colon as well as the cecum with stigmata of bleeding. Biopsy of a sigmoid ulcer was consistent with colonic tuberculosis. Antitubercular therapy was initiated, but the patient passed away secondary to multiorgan failure 29 days into admission.