A Boy with Disseminated Tuberculosis

Abstract

leucocytosis, increased CRP, and hyponatraemia. Lobar consolidation was seen in the left lung and nodular opacities were detected in the right lung ( Figure 1). The child was treated with intravenous antibiotics according to WHO guideline for pneumonia, intravenous fluids and oxygen via a nasal cannula.The child's condition did not improve over the following days, and he required non-invasive respiratory support by nasal continuous positive airway pressure. Three days later, he had a brief generalised seizure which was controlled by a single dose of rectal diazepam. Blood pressure was found to be 130/90 mmHg, pulse rate was 60/ minute, and random blood sugar level was 5.5 mmol/L. After the seizure, he remained semiconscious (GCS: 9/15) and was no longer able to move his right upper and lower limbs, together with ptosis, convergent strabismus, pupillary dilatation, and papilloedema in the right eye.Gastric lavage aspirate was examined for Mycobacterium tuberculosis. Smear microscopy was negative for acid fast bacilli. AbstractTuberculosis is a common infectious disease in developing countries. In the paediatric population, the disease can be manifested as pulmonary as well as extrapulmonary tuberculosis affecting multiple organs and systems at the same time. Delay in diagnosis and treatment can result in rapid progression of the disease with debilitating consequences in infants and young children because of weak immune defence mechanisms. We have described a case of disseminated tuberculosis involving the lungs, abdomen, lymphoreticular and central nervous systems.