Complicated Gastrointestinal Tuberculosis in Children: Case Report

Abstract

| http://medcraveonline.com lymphadenopathy, peritoneal tuberculosis, gastrointestinal tuberculosis and visceral tuberculosis of solid organs [2,7]. The clinical manifestations of the abdominal tuberculosis are nonspecific and can imitate many other diseases such as Crohn's disease, causing a delay in the diagnosis and therefore may present with complications [8-10]. We present the case of a 6 year old girl with multisystemic tuberculosis and intestinal involvement complicated by intestinal perforation. Case Report 6 year-old female patient entered the emergency department with abdominal pain, reporting one months history of diarrhoea with mucus and blood approximately 10 times per day, night fever, hiporexia and loss of weight not quantified. On examination: HR 110, RR:30 T: 38.3°C, Sat O 2 : 98%, awake, breathing spontaneously, pale and with decreased subcutaneous adipose tissue. Palpable cervical lymph nodes. Abdomen: Distended, tender and with resistance to palpation. Liver palpated 4 cm below right costal margin. No splenomegaly. The patient was admitted to the emergency department with the following diagnoses: Abdominal Sepsis, Chronic Diarrhea, Severe Malnutrition. She was later admitted to the department of Infectious Diseases for further investigations. During her hospitalization, she deteriorated and developed an acute surgical abdomen on day 3. An Abdominal X-ray showed a pneumoperitoneum (Figure 1), which was evaluated by the surgical service. The surgeons suggested an exploratory laparotomy. In theatre, they found multiple perforations secondary to obstructions in the ileum with mesenteric lymphadenitis. The enlarged lymph nodes appeared to contain caseous necrosis. Peritoneal cavity lavage, intestinal resection and Ileostomy were performed. A sample of intestinal tissue was sent for smear microscopy and culture which identified Mycobacterium tuberculosis complex (MTC). The immunocromatography, also detected the MTC and was sensitive to all the first-line anti-Volume 8 Issue 3-2017