a case of a disseminated TB in a child of 8 months with disseminated calcification

A Cas

Abstract We are admitted failure to chest x-calcified hepatosp and MR calcificat followed Introduc Tubercle including significan milliary numbers bloodstre leads to c Case rep Informan female c class res with com on and months; vomiting Child wa some IV Family h present. delivered perinatal age and developm On exam On clini HR- 110 90/62mm 11.5 less (no micr 2). Mid malnutrit On gene Spars h Wasting with bag from ch respirator present a

se report of

t

presenting a in pediatric o thrive and i -ray was ha lymph node lenomegaly RI Brain w tions. Patient d up regularly.

ction

bacilli are d g liver, skin

nt form of d disease, wh

of tubercle eam causing d calcifications. port

nt was a mot child coming siding at Veja mplaints of fev off; increase

not gaining g for 20 days.

as admitted m injection and history of tub

Child was d with birth

complication delayed dev mental quotien

mination: ical examina 0/min, RR- 32 mHg. Weight s than -3 SD) rocephaly); H arm circumf tion).

ral examinat air, pallor a

of muscle a ggy pant appe

heek). On ry system-b and on per a

f dissemina

Dr A 3rd Year R Smt. N

case of 8 m c ward with increased freq aving milliar es, ultrasonog

with multipl was also ha

was treated

disseminated lung and CN disseminated hich occurs e bacilli are disease to 2 or

ther of 8 mo from lower s alpur, Ahmed ver for 8 mon d frequency weight for many times in p

d oral medica berculosis to g

full term ca weight of ns. Child is velopment wa nt of 40%.

ation: Tempe 2/min, Spo2 4.2kg (again ; head circum eight- 63cm ference was tion:

and clubbing and loss of su

earance was systemic e bilateral cre abdominal ex

ated tuberc

c

Ashka M.Praj Resident*, Pro NHL Municip

month old ch h fever, coug

quency of sto ry opacity a graphy showi e calcificatio aving multip with ATT a

to distant si NS (1).The mo

tuberculosis when massi e released in r more organs

onth old Hin social econom dabad, admitt nths, low grad

of stool for 2 months a past at that tim ation was give

grandfather w aesarean secti 3 kg witho immunized f as present w

erature- norm 98% in air, B nst expected mferences 39 c (stunting grad 9.5 cm (seve

g was prese ubcutaneous

present (exce examination epitations w xamination liv

culosis in an

calcification

japati*, Dr A ofessor & He pal Medical C

hild gh, ool, and ing ons ple and tes ost is ive nto . It ndu mic ted de, r 2 and me en. was ion out for with mal, BP of cm de- ere ent. fat ept in was ver w m w sy In H su of ab w ex as sh A Fo O th im m re Su D di

n 8 month

n

Aasheeta S. Sh ad**, Dept. o College, Ahme

as enlarged + margin, granul as enlarge +3 ystem examina nvestigation a b 8.6; TC13 uggestive of b f milliary koc bdomen was ith multiple xamination wa spirate for A howing calcif ntitubercular t

ollow up n regular follo hree months mproved, weig mile stones wa

equired. ummary

iagnosis of ifficult1-4and a

old child w

hah** of Pediatric

edabad

5 cm with firm lar surface, n 3cm with firm ation was with and treatmen 3400; APC 2 bilateral granu ch’s (see figur suggestive o e calcificatio as normal; MT AFB was neg

fications. Pat treatment.

ow up, patient child’s ge ght gain was p as improved a

disseminated a high index o

Case

with dissem

m in consisten non tender an m in consisten

hin normal lim nt:

2.4; chest x- ular opacity s

re 1), Ultraso of hepatosple ons within

T was negativ ative. MRI b ient was trea

t responded w eneral condit present, devel and no any rea

d tuberculosis of suspicion is

e Report

inated

ncy ,sharp nd spleen ncy. Other mit. ray was suggestive onography nomegaly it. CSF ve, gastric brain was ated with

well and in tion was lopmental admission

s can be s required.

The resolution of milliary tuberculosis is slow, even with proper therapy. Fever usually declines within 2-3 weeks of starting ATT, but chest radiographic abnormalities might not resolve for many months. The appearance of calcifications implies that the lesion must be present for at least 6-12 months. The prognosis is excellent if diagnosis is made early and adequate chemotherapy is given. We should like to re-emphasize the need to consider disseminated tuberculosis early in differential diagnosis of a wasting pyrexial illness with chest symptoms and signs.3

References

1. Nelson textbook of pediatrics, 19th edition 2. The essentials of Tuberculosis, by Dr Vimlesh

Sheth

3. S Prout, et al. A Study of disseminated

tuberculosis medical jn 1980 -europepmc. org 4. Wang JY, et al. disseminated tuberculosis: a 10

year experience in medical center. Medicine (Baltimore). 2007 Jan;86 (1):39-46.