Case 4
An 18 years old boy presented with intestinal obstruction and underwent ileo-cecal resection
Operative biopsy showed chronic active inflammation favouring TB
Did not respond to anti-TB drugs over 4 months- developed oral ulcers - responded initially to steroid but had persistent pain abdomen even after steroid and Azathioprine (see Colonoscopy picture)
What is the next step?
Biologics + ganciclovir
IHC for CMV
Ganciclovir
Ganciclovir/valganciclovir + steroids
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CMV to be confirmed by IHC staining. Also duration of steroid is missing.
Patient needs:
CMV therapy
CT enterography
Biologics after assessing the underlying disease