A Rare Cause of Bloody Defecation: A Case Report

Abstract

Tuberculosis, which is mainly caused by the mammalian tubercle bacilli, Mycobacterium tuberculosis complex, is life-threatening disease transmitted from human-tohuman via the airborne route. Gastrointestinal tract (GIT) tuberculosis is usually caused by swallowing infected sputum or spread of bacilli smears to the GIT. A 36-year-old male patient presented to our outpatient clinic with a one-year history of weight loss, abdominal pain, nausea, and bloody stools for the past three months. Colonoscopy revealed giant and mucopurulent exudates in the cecum, ileocecal valve, and ileum. On histopathological examination, both ileum and ascending colon biopsies showed multiple granuloma formations with caseous necrosis and multinuclear giant cells. The Ehrlich-Ziehl-Neelsen histochemical staining revealed multiple foci of acid-fast bacilli compatible with Mycobacterium tuberculosis. Chest X-ray showed bilateral infiltration of the upper zones. Acid-resistant bacilli were positive in the sputum smear test. The patient was diagnosed with GIT and pulmonary tuberculosis and appropriate treatment was initiated. This rare case highlights the importance of accurate diagnosis of tuberculosis and delayed diagnosis can cause the bacteria to infect other organs through blood, lymphatic system, or direct spread.

Keywords

• Gastrointestinal tract tuberculosis
• Bloody stools
• Granuloma formations

Nadir Bir Kanlı Dışkılama Nedeni: Bir Olgu Sunumu

Abstract

Esas olarak memeli tüberküloz basili olan Mycobacterium tuberculosis kompleksinin neden olduğu tüberküloz, insandan insana hava yoluyla bulaşan hayatı tehdit eden bir hastalıktır. Gastrointestinal sistem (GIT) tüberkülozu genellikle enfekte balgamın yutulması veya basil yaymalarının GIT'e yayılmasından kaynaklanır. 36 yaşında erkek hasta bir yıldır kilo kaybı, karın ağrısı, bulantı ve son üç aydır kanlı dışkılama şikayetleri ile polikliniğimize başvurdu. Kolonoskopide çekum, ileoçekal valv ve ileumda dev ve mukopürülan eksudalar görüldü. Histopatolojik incelemede hem ileum hem de çıkan kolon biyopsilerinde kazeöz nekroz ve multinükleer dev hücreli çoklu granülom oluşumları görüldü. Ehrlich-Ziehl-Neelsen histokimyasal boyaması, Mycobacterium tuberculosis ile uyumlu asit hızlı basillerin çoklu odaklarını ortaya çıkardı. Göğüs röntgeni üst bölgelerin iki taraflı infiltrasyonunu gösterdi. Balgam yayma testinde aside dirençli basiller pozitifti. Hastaya GİT ve akciğer tüberkülozu tanısı konuldu ve uygun tedavi başlandı. Bu nadir vaka, tüberkülozun doğru teşhisinin önemini vurgular ve gecikmiş teşhis, bakterilerin kan, lenfatik sistem veya doğrudan yayılma yoluyla diğer organlara bulaşmasına neden olabilir.

Keywords

• Gastrointestinal sistem tüberkülozu
• Kanlı dışkı
• Granülom oluşumları

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