1.A Case of Reactivated Tuberculous Colitis After 9 Months of Anti-tuberculous Therapy.
You Sun KIM ; Jin Gook HUH ; Il KIM ; Soo Hyung RYU ; Jung Whan LEE ; Jeong Seop MOON
The Korean Journal of Gastroenterology 2004;44(6):337-341
Tuberculous colitis, an important extra-pulmonary tuberculosis, is still prevalent in the developing countries and has been resurging in the Western world. The duration and dose of anti-tuberculous therapy have not yet been clarified in the tuberculous colitis. We experienced a case of tuberculous colitis, which relapsed after 9 months of therapy. A 28-year-old man presented with hematochezia and was diagnosed as tuberculous colitis on the basis of colonoscopic findings. He was treated with anti-tuberculous agents for 9 months successfully. Three months later, however, he complained of hematochezia again, suggesting the relapse of tuberculous colitis. He had taken anti-tuberculous therapy for another 15 months and showed no evidence of relapse. Although anti-tuberculous therapy is efficient for tuberculous colitis, rare cases of reactivation should be reminded.
Adult
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Colitis/*drug therapy/microbiology
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English Abstract
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Humans
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Male
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Recurrence
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Tuberculosis, Gastrointestinal/*drug therapy
2.A Case of the Duodenal Tuberculosis Presenting as Hematemesis.
Hong Seong HA ; Dong Hyeon LEE ; Sang Je PARK ; Eun Kyu KIM ; No Won CHUNG ; Eun Young SEONG ; Woo Seog KO ; Ik Su CHOI ; Chul Soo SONG ; Yeong Kee SHIN ; Kyung Ha KANG
Korean Journal of Gastrointestinal Endoscopy 2000;21(2):638-641
Despite the modern advance in effective chemotherapy, gastrointestinal tuberculosis is considered to be relatively frequent in developing countries. The ileocecal region is the most common site of intestinal tuberculosis and duodenal involvement is rare. The isolated duodenal tuberculosis are reported 9 cases in Korea. The symptoms and signs of gastrointestinal tuberculosis are nonspecific and vague. In the absence of pulmonary tuberculosis, the diagnosis may be difficult. Pain and vomiting are common symptoms of duodenal tuberculosis. Patients may present with upper gastrointestinal bleeding. Therefore, tuberculosis should be considered in the differential diagnosis of gastrointestinal bleeding. We herein report a case of duodenal tuberculosis presenting as hematemesis and necessitating hospitalization. After anti-tuberculosis therapy, we have confirmed the healing of the lesion by the follow-up endoscopy, and review the current literature.
Developing Countries
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Diagnosis
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Diagnosis, Differential
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Drug Therapy
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Endoscopy
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Follow-Up Studies
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Hematemesis*
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Hemorrhage
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Hospitalization
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Humans
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Korea
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Tuberculosis*
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Tuberculosis, Gastrointestinal
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Tuberculosis, Pulmonary
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Vomiting
3.A Case of Duodenal Tuberculosis Associated with Hematemesis.
Hee Jin JUNG ; Hwon Taig SONG ; Chi Wook SONG ; Sang Woo LEE ; Chang Duck KIM ; Ho Sang RYU ; Jin Hai HYUN
Korean Journal of Gastrointestinal Endoscopy 1992;12(2):263-266
Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.
Aged
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Biopsy
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Developing Countries
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Diagnosis
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Drug Therapy
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Duodenal Ulcer
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Duodenum
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Electrocoagulation
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Endoscopy
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Female
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Follow-Up Studies
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Granuloma
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Hematemesis*
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Hemorrhage
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Humans
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Melena
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Necrosis
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Tuberculosis*
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Tuberculosis, Gastrointestinal
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Tuberculosis, Pulmonary
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Ulcer
4.A Case of Synchronous Intestinal Tuberculosis Involving the Stomach and Colon.
Joo Hyoung KIM ; Yong Cheol JEON ; Tae Yeob KIM ; Chang Soo EUN ; Joo Hyun SOHN ; Dong Soo HAN ; Jae Jung JANG ; Yong Wook PARK
The Korean Journal of Gastroenterology 2008;52(5):320-324
Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis and should be differentiated from the inflammatory bowel diseases and malignancy such as Crohn's disease, ulcerative colitis, amebic colitis, and colon cancer. Most frequently involved sites (75% of cases) are the terminal ileum and cecum. Other sites of involvement, in order of frequency, are ascending colon, jejunum, appendix, duodenum, stomach, esophagus, sigmoid colon, and rectum. Intestinal tuberculosis simultaneously involving the stomach and colon has been very rarely reported. Recently, we experienced a case of synchronous gastric and colonic ulcers with granulomatous inflammation. Although we did not find acid fast bacilli and the culture test was negative, empirical anti-tuberculosis therapy resulted in dramatic clinical and endoscopic improvement. We report a rare case of multifocal gastrointestinal tuberculosis with a review of literature.
Colonic Diseases/*diagnosis/pathology
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Colonoscopy
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Drug Therapy, Combination
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Female
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Gastroscopy
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Humans
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Middle Aged
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Stomach Diseases/*diagnosis/pathology
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Tomography, X-Ray Computed
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Tuberculosis, Gastrointestinal/*diagnosis/drug therapy/pathology
5.A Case of Acute Appendicitis due to Intestinal Stricture after Intestinal Tuberculosis Treatment.
Sang Bong AHN ; Dong Soo HAN ; Chang Soo EUN ; So Young BANG ; Young chul LEE ; Keum Nam RIM ; Yong Gu LEE ; Tae Yeob KIM
The Korean Journal of Gastroenterology 2007;50(4):277-279
Intestinal hemorrhage, perforation, obstruction, and fistula formation are the common complications associated with intestinal tuberculosis. However, these complications usually occurr in active stage of intestinal tuberculosis. A 45-year-old man was diagnosed as intestinal tuberculosis and received anti-tuberculosis medications for 9 months. After the end of treatment, intestinal lesion was cured. However a deformed appendiceal orifice due to hypertrophic sear resulting in symptomatic appendictis was noted. We report a case of acute appendicitis due to intestinal stricture after the successful treatment of intestinal tuberculosis.
Acute Disease
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Antitubercular Agents/therapeutic use
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Appendicitis/*diagnosis/etiology/surgery
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Colonoscopy
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Diagnosis, Differential
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Humans
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Male
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Middle Aged
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Tomography, X-Ray Computed
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Tuberculosis, Gastrointestinal/complications/*drug therapy
6.Asymptomatic Synchronous Tuberculosis Involving Stomach and Small Bowel in Immunocompetent Patient.
Jin Soo CHUNG ; Young Bum CHO ; Won Gak HEO ; Dong Ho JO ; Young Hun JEONG ; Geom Seog SEO
The Korean Journal of Gastroenterology 2015;66(6):345-349
Gastrointestinal tuberculosis that is not an unusual form of extrapulmonary tuberculosis and it is usually associated with immunocompromised condition that may present with clinical symptoms including fever, weight loss or pain. Terminal ileum and cecum are the common sites of involvement, but involvement of the stomach is rare. Furthermore, synchronous tuberculosis involving both the stomach and lower gastrointestinal tract has been reported in very few cases. Herein, we report a case of incidentally detected synchronous tuberculosis involving both the stomach and terminal ileum that was successfully treated by antituberculosis therapy in an asymptomatic immunocompetent patient.
Adult
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Antitubercular Agents/therapeutic use
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Asymptomatic Infections
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Drug Therapy, Combination
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Endoscopy, Digestive System
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Female
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Humans
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Intestine, Small/pathology
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Stomach/pathology
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Tomography, X-Ray Computed
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Tuberculosis, Gastrointestinal/*diagnosis/drug therapy
7.Imatinib mesylate-induced interstitial lung disease in a patient with prior history of Mycobacterium tuberculosis infection.
Na Ri LEE ; Ji Won JANG ; Hee Sun KIM ; Ho Young YHIM
The Korean Journal of Internal Medicine 2015;30(4):550-553
No abstract available.
Adult
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Antineoplastic Agents/*adverse effects
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Antitubercular Agents/therapeutic use
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Biopsy
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Female
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Gastrointestinal Stromal Tumors/*drug therapy/pathology/surgery
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Humans
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Imatinib Mesylate/*adverse effects
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Lung Diseases, Interstitial/*chemically induced/diagnosis
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Mycobacterium tuberculosis/*isolation & purification
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Protein Kinase Inhibitors/*adverse effects
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Rectal Neoplasms/*drug therapy/pathology/surgery
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Tomography, X-Ray Computed
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Tuberculosis, Pulmonary/diagnosis/drug therapy/*microbiology
8.A Case of Intestinal Tuberculosis Extensively Involving the Upper and Lower Intestinal Tract, Accompanied by Tuberculous Lymphadenitis.
Kang Seok SEO ; Jong Soon KIM ; Woon Tae OH ; Hyun Taek AHN ; Hyun Soo KIM ; Cheol KOO ; Sung Kyu CHOI ; Jong Sun REW ; Sei Jong KIM ; Chong Mann YOON
Korean Journal of Gastrointestinal Endoscopy 1998;18(3):408-415
The prevalence of intestinal tuberculosis has been markedly decreased with the development of anti-tuberculous chemotherapy, preventive medicine, vaccinations, early detection and treatment of pulmonary tuberculosis, and improved eeonomic conditions. Nowadays, intestinal tuberculosis is a disease that should be differentiated from the inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, Behcet's disease, and colon cancer and amebic colitis. This disease also has a new clinical significance in that it has an increased infection rate and unfavorable outcomes in patients infected by HIV or in those who undergo organ transplantation or receive immunosuppressive agents. Tuberculosis of the duodenum was a rare disease and was not reported in the last decade. Moreover Intestinal tuberculosis extensively involving the small bowel including the duodenum and colon was very rarely reported in the various relateid literature. Recently we experienced a case of advanced intestinal tuberculosis involving the duodenum, jejunum, ileum, and colon accompanied by tuberculous cervical and abdominal lymphadenopathies, in a 49-year-old woman who manifested profound general weakness, diarrhea, and marked weight loss. She was diagnosed pathologically by upper gastrointestinal endoscopy, colonoscopy, and fine needle aspiration cytology as well as by roentgenologic examination. The patient was given antituberculous medication which resulted in dramatic clinical improvement. In this report, we present this case with review of the related literature.
Biopsy, Fine-Needle
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Colitis, Ulcerative
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Colon
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Colonic Neoplasms
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Colonoscopy
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Crohn Disease
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Diarrhea
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Drug Therapy
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Duodenum
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Dysentery, Amebic
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Endoscopy, Gastrointestinal
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Female
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HIV
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Humans
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Ileum
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Immunosuppressive Agents
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Inflammatory Bowel Diseases
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Jejunum
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Middle Aged
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Organ Transplantation
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Prevalence
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Preventive Medicine
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Rare Diseases
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Transplants
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Tuberculosis*
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Tuberculosis, Lymph Node*
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Tuberculosis, Pulmonary
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Vaccination
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Weight Loss
9.Clinical Outcome of Treatment with Infliximab in Crohn's Disease: A Single-Center Experience.
Yeon Ju KIM ; Jung Wook KIM ; Chang Kyun LEE ; Hyun Jin PARK ; Jae Jun SHIM ; Jae Young JANG ; Suk Ho DONG ; Hyo Jong KIM ; Byung Ho KIM ; Young Woon CHANG
The Korean Journal of Gastroenterology 2013;61(5):270-278
BACKGROUND/AIMS: Our aim was to assess the long-term data regarding efficacy and safety of infliximab (IFX) treatment for refractory Crohn's disease (CD) patients in our tertiary teaching hospital. METHODS: We have retrospectively analyzed the medical records of 89 CD patients who underwent IFX treatment between March 2003 and February 2011 at Kyung Hee University Hospital (Seoul, Korea). The primary outcome measurements were the rates of initial clinical response (CR) at 10 weeks after the 1st IFX infusion and sustained CR at the end of the follow-up. Overall adverse events related to IFX treatment were also evaluated. RESULTS: The mean (SD) follow-up period of eligible 80 patients was 33.7 (21.9) months. A total of 77 patients (96%) showed initial clinical response, but 8 patients showed loss of response to IFX during the follow-up. Finally, 59 patients (59/77, 76.6%) showed sustained CR at the end of the study. Logistic regression analyses showed that an initial CR at 10 weeks was the independent predictor associated with sustained CR (OR 22.286, 95% CI 2.742-132.717, p=0.001). Overall adverse events reported in 18 patients (18/80, 23.3%), including 3 serious infection (pulmonary tuberculosis and herpes zoster). CONCLUSIONS: Treatment with IFX was efficacious and relatively safe for refractory CD patients in Korea. An initial CR at 10 weeks was significantly associated with sustained CR.
Adult
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Antibodies, Monoclonal/adverse effects/*therapeutic use
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Crohn Disease/*drug therapy
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Female
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Follow-Up Studies
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Gastrointestinal Agents/adverse effects/*therapeutic use
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Herpes Zoster/etiology
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Humans
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Logistic Models
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Male
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Odds Ratio
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Retrospective Studies
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Treatment Outcome
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Tuberculosis, Pulmonary/etiology
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Young Adult
10.A Case of Pseudomembranous Colitis Associated with Rifampicin Therapy in a Patient with Rectal Cancer and Gastrointestinal Tuberculosis.
Yong Jun CHOI ; Hyung Gil KIM ; Yun Ah CHOI ; Woo Chul JOO ; Dong Wook SON ; Chul Hyun KIM ; Yong Woon SHIN ; Young Soo KIM
The Korean Journal of Gastroenterology 2009;53(1):53-56
Pseudomembranous colitis (PMC) is known to be associated with the administration of antibiotics which alter normal gastrointestinal flora and allow overgrowth of Clostridium difficile. Most cases of rifampicin-induced PMC are seen in patients with pulmonary tuberculosis, but not with gastrointestinal tuberculosis. We report a case of PMC associated with rifampicin therapy in a patient with gastrointestinal tuberculosis. A 65-year-old female patient with rectal cancer and gastrointestinal tuberculosis was admitted due to abdominal pain and diarrhea. She was treated with anti-tuberculosis agents containing rifampicin. On colonoscopic examination, mucoid exudates and yellowish plaque lesions were observed. Anti-tuberculosis agents were stopped, and the patient was treated with metronidazole. Symptoms were relieved and did not recur when all the anti-tuberculosis agents except rifampicin were started again. When a patient complains of abdominal pain or diarrhea while taking rifampicin, the physician should consider the possibility of rifampicin-associated PMC.
Aged
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Antibiotics, Antitubercular/*adverse effects/therapeutic use
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Enterocolitis, Pseudomembranous/*diagnosis/etiology/pathology
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Female
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Humans
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Rectal Neoplasms/*complications/diagnosis
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Rifampin/*adverse effects/therapeutic use
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Sigmoidoscopy
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Tuberculosis, Gastrointestinal/complications/diagnosis/*drug therapy