INTRODUCTION
Intestinal tuberculosis (ITB) and Crohn’s disease (CD) are similar
chronic granulomatous diseases making a real diagnostic
problem.1, 2 Gastrointestinal tuberculosis is
responsible for significant morbidity and mortality but can be cured
with anti-tuberculosis chemotherapy for 6 months. Its frequency is
estimated at 3-5%.2, 3 Crohn’s disease is a chronic
disease that progresses over time and requires lifelong treatment to
maintain remission. It has a high prevalence in industrialized countries
but rare in Africa, especially in Sub-Saharan Africa.3,
4 It is notoriously difficult to differentiate ITB from CD, due to the
similarity between the two pathologies from a clinical, radiological,
endoscopic and even histopathological point of view.1,
3 Confusion between these two diseases can lead us to erroneously
prescribe corticosteroid therapy. This can worsen the symptoms of
tuberculosis (TB) and promote the development of
complications.5-7 The elimination of ITB before the
initiation of immunosuppressive therapy remains fundamental in the event
of inflammatory ileo-colitis. Our objective is to report two cases of
disseminated TB with digestive involvement revealed following
corticosteroid therapy in order to alert our colleagues in endemic areas
to the dangerousness of initiating corticosteroid therapy without
formally ruling out ITB.