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Learning from errors
CASE REPORT
Intestinal granulomatous disease: what is the first call
  1. Alex Guri1,
  2. Michal Kori1,
  3. Pearl Herskovitz2,
  4. Oren Zimhony3
  1. 1 Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel
  2. 2 Department of Radiology, Kaplan Medical Center, Rehovot, Israel
  3. 3 Infectious Diseases Unit, Kaplan Medical Center, Rehovot, Israel
  1. Correspondence to Dr Alex Guri, alexgur{at}clalit.org.il, alexguri{at}gmail.com

Summary

A 15-year-old girl presented with erythema nodosum and mild abdominal complaints. Her intestinal granulomatous disease was erroneously diagnosed as Crohn’s disease despite the fact that the possibility of tuberculosis was considered. The final diagnosis of tuberculosis was made only when an anti-tumour necrosis factor therapy resulted in further deterioration. The patient was treated with isoniazid, rifampin, pyrazinamide and ethambutol, with slow and steady clinical improvement until complete recovery was achieved.

  • Tb and other respiratory infections
  • crohn’s disease

https://doi.org/10.1136/bcr-2017-223094

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    Footnotes

    • Contributors All authors contributed to the manuscript as follows: AG, MK and OZ: detailed discussion and analysis of the case. AG: drafting the article. MK and OZ: revising the manuscript critically for important remarks. PH: analysis of roentgenological (CT) studies. AG, MK, PH and OZ: final approval of the manuscript. AG and MK: contributed equally for this case report preparation.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.