PMC4531579_01
(A) Initial chest PA at the time of diagnosis of pulmonary tuberculosis. Chest PA shows multiple irregular pathological consolidations on both lung fields. (B) Follow up of chest PA on admission (1.5 months later after antitubercular agents were started). Chest PA shows further improvement of the multiple irregular pathological consolidations on both lung fields.
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His chest X-ray showed little change during this interval compared with the previous films (Figure 1).
Sigmoidoscopic appearance of the colon. (A) At admission (1.5 months later after the antitubercular agents were started), the sigmoidoscope procedure revealed multiple yellowish plaque lesions from the rectum to sigmoid colon. (B) At readmission (1 month later after the antitubercular agents were restarted), it shows diffuse white plaque and debris on the colonic mucosa from the rectum to the sigmoid colon, with scattered whitish erosion. (C) 2 months later after the antitubercular agents were retried with regimen of 3 drugs except RFP, sigmoidoscopy shows a nearly improved state of colitis and no evidence of recurrence of PMC.
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Sigmoidoscopy revealed multiple yellowish plaque lesions from the rectum to the sigmoid colon (Figure 2A), and mucosal biopsy from the sigmoid colon showed chronic inflammation with mucous exudates (Figure 3). So sigmoidoscopy was again done and it revealed diffuse white plaque and debris on the colon mucosa from the rectum to the sigmoid colon, with scattered whitish erosion (Figure 2B). The patient had no further recurrence of diarrhea, and he recovered his general condition; the follow-up sigmoidoscopy did not show any evidence of recurrent PMC (Figure 2C), and he was then discharged.
Sigmoidoscopic mucosal biopsy. Mushroom-shaped pseudomembrane is made up of inflammatory cells, fibrin, and necrotic debris (Hematoxylin and eosin stain, x40).
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Sigmoidoscopy revealed multiple yellowish plaque lesions from the rectum to the sigmoid colon (Figure 2A), and mucosal biopsy from the sigmoid colon showed chronic inflammation with mucous exudates (Figure 3).