Life Science Journal 2013; 10(9s) http://www.lifesciencesite.com 280 Ileocecal tuberculosis as a cause of weight loss (return to an old disease): a case report Shahla Afrasiabian 1 Alireza Gharib 2* Abbas Ahmadi 3 Farshad Sheikhesmaeili 4 1 Department of Infectious Diseases, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. 2* Deputy of Research and Technology, Kurdistan University of Medical Sciences, Sanandaj, Iran. 3 Department of Hematology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. 4 MD, Gastroenterologist and Hepatologist, Kurdistan Digestive Research Center, Sanandaj, Iran. *Corresponding Author: gharibalireza@yahoo.com Abstract: Ileocecal tuberculosis (TB) is an uncommon disease. Diagnosis is often delayed or messed up with other disorders like Crohn's disease due to the lack of specific symptoms and laboratory findings. As a result, effective treatment is deferred with ensuing morbidity and mortality. A 53-year-old male patient was admitted to Besat hospital, Sanandaj, Iran. He suffered from mild abdominal pain, weight loss, and low-grade fever and lymphadenopathy (LAP). Antituberculosis medication during hospitalization and after discharge resulted in weight gain and lymphadenopathy improvement. In conclusion, Intestinal TB should always be kept in mind while investigating the conditions such as weight loss, abdominal pain, lymphadenopathy, perforation, obstruction or bleeding of the intestines, especially in the endemic regions. Here, we present a rare case of Ileocecal tuberculosis (TB) with weight loss. .[Shahla Afrasiabian, Alireza Gharib, Abbas Ahmadi , Farshad Sheikhesmaeili. Ileocecal tuberculosis as a cause of weight loss (return to an old disease): a case report. Life Sci J 2013;10(9s):280-283] (ISSN:1097-8135). http://www.lifesciencesite.com . 39 Key words: Intestinal Tuberculosis, Tuberculosis (TB), Abdominal computed tomography (CT), Colonoscopy, Weight loss, Intestinal obstruction. Introduction Being a major global health problem Tuberculosis (TB) has a high burden of disease globally(1, 2). It kills about two million people annually(3). TB can affect different organs of the body such as respiratory and gastrointestinal systems(4). Despite considerable progress made in therapy and prophylaxis during the past 25 years, intestinal tuberculosis contributes as a major health hazard. In recent years a resurgence of the disease occurred in the west, which could be due to the AIDS epidemic and increased global migration. This widespread malady with its protean profiles and varied complications continues to challenge the diagnostic and therapeutic skill of clinicians. The significance of correct diagnosis is vital, since untreated cases could face with high mortality rate(5). Tuberculosis is one of the major health problems in Iran; nevertheless the problem grows deeper due to immigrants and pilgrims from Pakistan and Afghanistan(6). Diagnosis of intestinal TB is often postponed due to the lack of specific symptoms and laboratory findings. This owes to the difficulty of identifying the mycobacterium tuberculosis in the samples taken from lower GI endoscopy (identified in less than 18% of cases), as well as the fact that diffuse tuberculosis of the colon appears very similar with Crohn's disease (7). Intestinal Tuberculosis is a rare form of tuberculosis and is found in immunosuppressed patients, usually with the clinical appearance of Crohn's disease(8). As a result, effective treatment is delayed with ensuing morbidity and mortality(9). Therefore recognizing rare cases of tuberculosis can improve clinician practice and save patients life in countries with high burden of the disease(10). For this reason colonoscopy was introduced as a primary screening tool. The purpose of this article is to report a rare case of Ileocecal tuberculosis, presenting in the form of bowel obstruction. Case report A 53-year-old male patient was admitted to Besat hospital in Sanandaj, Iran, he had non productive cough, shortness of breath, sweating, epigastric pain, weight loss (the patient was 45 kg), low-grade fever, nausea, and vomiting. The patient has been admitted several times with the same presenting problems in addition to chronic cough. Then pulmonary tuberculosis was investigated using appropriate investigative modalities like CT scan, sputum cytology, and bronchoscopy. Finally after colonoscopy he was admitted in the infectious disease ward with the diagnosis of Ileocecal tuberculosis. Barium follow-through procedure findings suggest a chronic inflammatory lesion, more likely TB. However, Crohne's disease is included in the differential diagnosis, requiring histopathologic evaluation. Other less likely differentials include lymphoma in the chronic clinical setting, and