Case report: Isolated gastric tuberculosis of the cardia

Background: Isolated gastric tuberculosis is extremely fare, especially in the subcardiac region, where the low pH, high motility and absence of lymph oid tissue result in an unfavourable environment for the development of tub erculous lesions. Methods and Results: Here we present a case of isolated gastric tuberculosi s in the gastric cardia with no evidence of pulmonary involvement. Our pati ent was a young man with vague gastrointestinal symptoms and no previous hi story of tuberculosis. His condition was first detected on upper endoscopy as a raised subcardiac ulcer similar in appearance to a submucosal tumour. An endoscopic forceps biopsy showed the presence of caseating granulomata a nd acid-fast bacilli. The lesion resolved completely with 12 months of oral anti-tuberculosis therapy. Conclusions: This case illustrates the need for a high index of suspicion i n order to diagnose this rare condition, as it can present in patients with no particular risk factors or symptoms. Once diagnosed, a complete cure ca n often be achieved with a course of oral anti-tuberculosis medication, wit h surgery being reserved for severely symptomatic or refractory lesions.