New! Image highlight: Tuberculosis of the ileum

Welcome to the new ‘Image highlight’ section of our JMCR blog. Since launch, we have published hundreds of fascinating photographs, histology slides, X-rays, CT scans and more, so this is our opportunity to highlight some great images from our case reports that you may have missed. This week’s image is taken from a recently published case report by Dr Taraneh Dormohammadi Toosi et al., Imam Khomeini Hospital, Iran:

X-ray of small bowel barium transit showing narrowing and irregularity of the terminal ileum and ulceration in its wall, highly suspicious for tuberculosis.


A 14-year-old girl presented with complaints of paraplegia, ataxia, fever and fatigue that had started a few months earlier, which had progressively worsened in the last three weeks. Her laboratory results were indicative of macrocytic anemia with a serum B12 level <100 (normal, 160-970) pg/ml and hypersegmented neutrophils and MRI revealed brain atrophy. Her fever workup eventually led to the diagnosis of tuberculosis, documented by bone marrow aspiration smear & culture. A small bowel series showed that tuberculosis had typically involved the terminal ileum which had resulted in vitamin B12 deficiency. She was treated for vitamin B12 deficiency and tuberculosis. Her fever ceased and her hemoglobin level returned to normal. This is the first report of macrocytic anemia with unusual manifestations such as brain atrophy and seizures due to intestinal tuberculosis. [View full case report and more images]


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