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Review
. 2019 Apr 10:32:173.
doi: 10.11604/pamj.2019.32.173.17893. eCollection 2019.

[Intestinal tuberculosis revealed by acute bowel obstruction during paradoxical reaction to antituberculosis treatment in an immunocompetent patient: about a case and literature review]

[Article in French]
Bruce Wembulua Shinga  1 , Alassane Dièye  2 , Ndèye Méry Dia Badiane  2 , Ndèye Aissatou Lakhe  1 , Viviane Marie-Pierre Cisse Diallo  1 , Khadiatou Diallo Mbaye  1 , Daye Ka  1 , Aboubakar Sidikh Badiane  1 , Assane Diouf  1 , Louise Fortes Déguénonvo  1 , Cheikh Tidiane Ndour  1 , Moussa Seydi  1
Affiliations
Review

[Intestinal tuberculosis revealed by acute bowel obstruction during paradoxical reaction to antituberculosis treatment in an immunocompetent patient: about a case and literature review]

[Article in French]
Bruce Wembulua Shinga et al. Pan Afr Med J. .

Abstract
in English, French

Abdominal tuberculosis accounts for 3 to 5% of all visceral diseases. Despite the demonstrated effectiveness of anti-tuberculosis treatments, some cases of exacerbation of the initial clinical presentation have been described during the initiation of treatment. However, these reactions also known as "paradoxical" have been rarely reported in immunocompetent patients and much less in the case of bowel obstruction. We report a case of intestinal tuberculosis revealed by acute bowel obstruction during paradoxical reaction to anti-tuberculosis treatment. The study included a 26-year old immunocompetent patient with occlusive syndrome after a month of treatment for pleuropulmonary tuberculosis. Abdominal computed tomography (CT) showed small bowel obstruction. Laparotomy objectified intraperitoneal mass with multiple adhesions. Anatomo-pathological examination of the surgical specimen showed intestinal tuberculosis. Patient's outcome was favorable after the continuation of initial antituberculosis treatment.

La tuberculose intestinale représente 3 à 5% de toutes les localisations viscérales. Malgré l'efficacité démontrée des anti-tuberculeux, des cas d'exacerbation du tableau clinique initial ont été décrits à l'initiation du traitement. Ces réactions dites «paradoxales» sont cependant rarement rapportées chez les immunocompétents et beaucoup moins sous forme d'occlusion intestinale. Nous rapportons un cas de tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d'une réaction paradoxale aux anti-tuberculeux. Il s'agit d'un patient de 26 ans, immunocompétent qui a présenté un syndrome occlusif à un mois de traitement d'une tuberculose pleuro-pulmonaire. La tomodensitométrie (TDM) abdominale était en faveur d'une occlusion intestinale grêlique. La laparotomie objectivait une masse intra-péritonéale avec de multiples adhérences. L'examen anatomopathologique de la pièce opératoire était en faveur d'une tuberculose intestinale. L'évolution était favorable après la poursuite du traitement anti-tuberculeux initial.

Keywords: Intestinal tuberculosis; acute bowel occlusion; paradoxical reaction.

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Conflict of interest statement

Les auteurs ne déclarent aucun conflit d'intérêts.

Figures

Figure 1
Figure 1
radiographie de l’abdomen sans préparation montrant des niveaux hydo-aériques de type grélique
Figure 2
Figure 2
TDM abdominale montrant une dilation d’anses contrastant avec des anses plates et un côlon plat
See this image and copyright information in PMC

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