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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This case concerns a 49-year-old woman from the Philippines who has been residing in Spain for the last few years and who has a history of chronic kidney disease undergoing dialysis&#46; The patient was being studied for fever of unknown origin and recurrent pneumonia for the last 6 months with inconclusive results&#46; The patient underwent positron emission tomography&#47;computed tomography&#44; which revealed hypermetabolic uptake at multiple levels &#40;including cervical lymph nodes&#44; lungs&#44; liver and cecum&#41;&#46; During the colonoscopy&#44; we observed a patulous ileocecal valve&#44; with punched-out mucous ulcers &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Histologically&#44; these corresponded to extensively ulcerated intestinal mucosa&#44; with clusters of epithelioid macrophages&#44; giant cells and acid&#8211;alcohol-resistant bacilli isolates detected with Ziehl-Neelsen staining &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> &#91;H&#38;E 100&#215;&#93;&#46; Inset&#58; magenta intracellular bacillary structures &#91;Ziehl-Neelsen 1000&#215;&#93;&#41;&#46; Among the granulomas&#44; we observed hyaline-crenulated membranes characteristic of lipomembranous fat necrosis &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#59; H&#38;E 400&#215;&#41;&#46; The polymerase chain reaction for <span class="elsevierStyleItalic">M&#46; tuberculosis</span> was positive&#46; These findings enabled the diagnosis of disseminated tuberculosis&#44; which would not have been possible with other procedures&#44; including direct smears for bacilli and fibrobronchoscopy&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Intestinal tuberculosis is a chronic infection caused mainly by the bacteria <span class="elsevierStyleItalic">M&#46; tuberculosis</span>&#46; The disease usually develops after pulmonary involvement by the swallowing of sputum&#46; Clinically nonspecific&#44; this condition can present as chronic abdominal pain&#44; diarrhea&#44; constipation or febricula&#46; Intestinal tuberculosis mainly affects the ileocecal valve and terminal ileum and is indistinguishable from Crohn&#39;s disease&#46; Histologically&#44; the disease is characterized by caseous epithelioid granulomas with giant cells&#46; Lipomembranous fat necrosis is an uncommon phenomenon that has recently been reported in this infection&#46; Polymerase chain reaction is highly specific &#40;95&#37;&#41; although insensitive &#40;47&#37;&#41;&#44; and therefore a negative result does not rule out the diagnosis&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Yebra Carmona J&#44; de Mar&#237;a Pallares P&#44; Blasco Santana L&#46; Diagn&#243;stico endosc&#243;pico e histol&#243;gico de un caso de tuberculosis diseminada con afectaci&#243;n intestinal y necrosis grasa lipomembranosa&#46; Rev Clin Esp&#46; 2020&#59;220&#58;141&#8211;142&#46;</p>"
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March 2020 Endoscopic and histological diagnosis of a case of disseminated tuberculosis with...
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Vol. 220. Issue 2.
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Vol. 220. Issue 2.
Pages 141-142 (March 2020)
Medicine in Images
DOI: 10.1016/j.rceng.2019.01.004
Endoscopic and histological diagnosis of a case of disseminated tuberculosis with intestinal affectation and lipomembranous fat necrosis
Diagnóstico endoscópico e histológico de un caso de tuberculosis diseminada con afectación intestinal y necrosis grasa lipomembranosa
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J. Yebra Carmonaa,
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yebra.jorge@gmail.com

Corresponding author.
, P. de María Pallaresa, L. Blasco Santanab
a Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, Spain
b Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, Spain
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?