- Louis-Michel Wong Kee Song, MD, FRCP(C)
Louis-Michel Wong Kee Song, MD, FRCP(C)
- Associate Professor of Medicine
- Mayo Clinic College of Medicine
- Norman E Marcon, MD, FRCP(C)
Norman E Marcon, MD, FRCP(C)
- Professor of Medicine
- University of Toronto
Extrapulmonary tuberculosis (TB) affects approximately 20 percent of TB cases in immunocompetent individuals and 50 percent of cases in HIV-infected patients. Tuberculous enteritis is a form of extrapulmonary TB that can involve any aspect of the gastrointestinal tract. It accounts for 1 to 3 percent of TB worldwide  and represents the sixth most frequent form of extrapulmonary TB (after lymphatic, genitourinary, bone and joint, miliary, and meningeal tuberculosis) . The epidemiology of tuberculous enteritis varies widely around the globe, influenced in part by age, sex, socioeconomic factors, immune status, and Mycobacterium tuberculosis genotype . Young adults, primarily women, are mostly affected in regions like Pakistan, Turkey, and West Africa, whereas a lower disease incidence but similar or greater numbers of male patients are reported in studies from China, Singapore, India, and the United Kingdom .
Prior to antituberculous therapy, gastrointestinal involvement was observed in 55 to 90 percent of patients with active pulmonary TB but since has been observed in approximately 25 percent of cases .
Issues related to gastrointestinal TB will be reviewed here; issues related to other aspects of extrapulmonary TB are discussed separately. (See "Clinical manifestations, diagnosis, and treatment of miliary tuberculosis".)
The pathogenesis of tuberculous enteritis has been attributed to four mechanisms [5-7]:
●Swallowing infected sputum
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