An immunocompetent 70-year-old male presented with chronic abdominal pain, weight loss, and diarrhea, initially suggestive of Crohn's disease. Endoscopy revealed inflammatory changes and ulcerations in the terminal ileum and colon. Histopathology showed granulomatous inflammation, and subsequent PCR confirmed Mycobacterium tuberculosis. This led to a diagnosis of gastrointestinal tuberculosis (GI TB). The patient responded well to anti-tuberculous therapy. This case highlights the diagnostic challenge of GI TB due to its non-specific symptoms, often mimicking inflammatory bowel disease, even in immunocompetent individuals. Early molecular diagnosis is crucial for timely and effective treatment, preventing complications.
Key note: Gastrointestinal tuberculosis can present atypically in immunocompetent patients, necessitating a high index of suspicion and molecular diagnostic methods.