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

• Published in: The Pan African medical journal Vol. 32; p. 173
• Main Authors: Shinga, Bruce Wembulua, Dièye, Alassane, Badiane, Ndèye Méry Dia, Lakhe, Ndèye Aissatou, Diallo, Viviane Marie-Pierre Cisse, Mbaye, Khadiatou Diallo, Ka, Daye, Badiane, Aboubakar Sidikh, Diouf, Assane, Déguénonvo, Louise Fortes, Ndour, Cheikh Tidiane, Seydi, Moussa
• Format: Journal Article
• Language: French
• Published: Uganda 2019
• Subjects: acute bowel occlusion; paradoxical reaction; Intestinal tuberculosis
• ISSN: 1937-8688
• DOI: 10.11604/pamj.2019.32.173.17893

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.