Etiology of chronic non-bloody diarrhoea with fever

Chronic diarrhoea, emaciation and persistent fever are important criteria for the clinical diagnosis of AIDS. Other clinical signs should be searched for, such as oral candidiasis, Kaposi’s sarcoma lesions, chronic pruritus, severe or repetitive shingles. Serology can confirm the diagnosis. Intestinal parasites must be searched for.

Tuberculosis of the intestine is predominantly sited at the ileocaecal transition. A mass can sometimes be felt there on palpation. There is sometimes ascites due to concomitant involvement of the peritoneum. Pulmonary lesions can be present, but these are certainly not a requirement for the diagnosis of intestinal TB. It is difficult to differentiate intestinal tuberculosis from Crohn's disease because of similar clinical, pathological, radiological, and endoscopic findings. Histological interpretation of biopsies is of limited diagnostic value in the differentiation of intestinal tuberculosis from Crohn's disease, except when caseating granulomata are found. Mycobacterial culture (isolation of Mycobacterium tuberculosis) and PCR are helpful in making the distinction between intestinal tuberculosis and Crohn's disease.

Category: Medical Subject Notes , Medicine Notes