RESUMO
Even though tuberculosis is considered rare in developed countries, its rising incidence, especially in high-risk populations, places intestinal tuberculosis in the differential diagnosis of patients with atypical abdominal symptoms or signs. We, herein, report the case of an immunocompetent woman, from a nonendemic area, who developed intestinal tuberculosis, emphasizing the diagnostic challenges caused due to nonspecific symptoms, inconclusive clinical, laboratory, and imaging findings, which could not rule in or rule out tuberculosis. Antituberculosis treatment was administered based on endoscopic findings and histological features of mucosal biopsies, which were indicative of intestinal tuberculosis, and the patient showed a marked clinical and laboratory improvement. We also review the evidence with regard to the diagnostic accuracy of the different available tests for intestinal tuberculosis.
Assuntos
Tuberculose Gastrointestinal/diagnóstico , Adulto , Antituberculosos/uso terapêutico , Biópsia , Colo/patologia , Colonoscopia , Diagnóstico Diferencial , Feminino , Seguimentos , Mucosa Gástrica/patologia , Humanos , Imunocompetência , Mucosa Intestinal/patologia , Tuberculose Gastrointestinal/tratamento farmacológico , Tuberculose Gastrointestinal/imunologia , Tuberculose Gastrointestinal/patologiaRESUMO
4,4'-Methylenedianiline (MDA) is a chemical used in manufacturing and insulation processes and is a well-known hepatotoxin. We report the case of a 42-year-old construction-site worker who was accidentally exposed to large amounts of MDA and developed acute liver damage. The clinical course is described, with particular emphasis on the timely identification of the underlying cause and prompt management that led to an uneventful recovery. We review the relevant literature and discuss the safety measures necessary to minimize similar occupational hazards in industrial workers.
