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Z Gastroenterol 2019; 57(09): 1067-1076
DOI: 10.1055/a-0981-6580
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Herausforderungen in der Diagnostik der Darmtuberkulose – Pitfalls einer vergessenen infektiösen Erkrankung: Eine Fallserie und Literaturübersicht

Challenges in diagnostics for intestinal tuberculosis – Pitfalls of a forgotten infectious disease: case series and literature review
Christoph Ammer-Herrmenau
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
,
Patrick Henrici
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
,
Helmut Eiffert
2   Institut für medizinische Mikrobiologie der Universitätsmedizin Göttingen
,
Ahmad Amanzada
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
,
Nicolae-Catalin Mechie
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
,
Felix Bremmer
3   Institut für Pathologie der Universitätsmedizin Göttingen
,
Ali Seif Amir Hosseini
4   Institut für Diagnostische und Interventionelle Radiologie der Universitätsmedizin Göttingen
,
Volker Ellenrieder
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
,
Edris Wedi
1   Klinik für Gastroenterologie und gastrointestinale Onkologie der Universitätsmedizin Göttingen
› Author Affiliations
Further Information

Publication History

04 May 2019

17 July 2019

Publication Date:
16 September 2019 (online)

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Zusammenfassung

Die Darmtuberkulose ist eine extrapulmonale Manifestation einer Infektion mit Mykobakterien des Tuberkulosekomplexes. Sie ist in den Industrieländern äußerst selten geworden, präsentiert sich mit einer sehr heterogenen, unspezifischen Klinik und ist schwer zu diagnostizieren. Anders als bei der pulmonalen Tuberkulose besitzen die wichtigsten diagnostischen Methoden wie der Nachweis säurefester Stäbchen in der Ziehl-Neelsen-Färbung, der Genomnachweis mittels PCR-Untersuchung und die kulturelle Anzüchtung der Bakterien eine geringe Sensitivität. Wir präsentieren hier die Fälle von drei Patienten/-innen, bei denen wir eine Darmtuberkulose diagnostizierten und erfolgreich behandelten. An die Fallberichte anschließend stellen wir eine Literaturübersicht vor, die die Fallstricke der Darmtuberkulosediagnostik und -therapie beleuchtet.

Abstract

Intestinal tuberculosis is an infectious disease of the extrapulmonary manifestation with the Mycobacteria tuberculosis complex. In developed countries, this disease is rarely seen. The clinical features are heterogeneous and unspecific. Furthermore, intestinal tuberculosis poses diagnostic challenges. Regarding intestinal tuberculosis the Ziehl-Neelsen staining for acid-fast bacillus, PCR examination and culture methods show only poor sensitivity and specificity. In this case series, we present three patients suffering from intestinal tuberculosis, who were diagnosed and treated successfully. Furthermore, we review the literature about the pitfalls of the diagnostic approaches and the treatment options of intestinal tuberculosis.

Schlüsselwörter

Intestinale Tuberkulose (TB) - Abdominelle Tuberkulose - Interferon γ releasing assay (IGRA) - Gastrointestinaltrakt

Key words

intestinal tuberculosis (tb) - abdominal tuberculosis - interferon gamma releasing assay IGRA - gastrointestinal tract
 

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