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 ; Antitubercular Agents/therapeutic use ; Appendicitis/*diagnosis/etiology/surgery ; Colonoscopy ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Tuberculosis, Gastrointestinal/complications/*drug therapy

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 ; Antibiotics, Antitubercular/*adverse effects/therapeutic use ; Enterocolitis, Pseudomembranous/*diagnosis/etiology/pathology ; Female ; Humans ; Rectal Neoplasms/*complications/diagnosis ; Rifampin/*adverse effects/therapeutic use ; Sigmoidoscopy ; Tuberculosis, Gastrointestinal/complications/diagnosis/*drug therapy