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Common in developing nations; rare in the United States, except in immigrant groups or in patients with untreated AIDS
Caused by Mycobacterium tuberculosis and Mycobacterium bovis
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Active pulmonary tuberculosis in < 50%
Most common involvement is ileocecal
Chronic abdominal pain, obstructive symptoms, weight loss, diarrhea
Abdominal mass palpable
Complications include
Intestinal obstruction
Hemorrhage
Fistula formation
Differential diagnosis
Crohn disease
Carcinoma
Lymphoma
Intestinal amebiasis
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PPD skin test may be negative, especially in weight loss or AIDS
Abdominal CT
Colonoscopy
Definitive diagnosis by either endoscopic or surgical biopsy revealing acid-fast bacilli and caseating granuloma or by positive cultures
Detection of tubercle bacilli in biopsy specimens by polymerase chain reaction
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