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Severe disseminated tuberculosis in a 4-month-old infant initially presenting with multiform cutaneous lesions

Nikos Spyridis1, Heleni Georgouli, Theano Tsoukatou

  • 1Department of General Paediatrics, St Thomas' Hospital, London, UK. niksp@netbreeze.co.uk

Scandinavian Journal of Infectious Diseases
|May 25, 2006
PubMed

Insights

Disseminated tuberculosis in an infant caused horizontal nystagmus and skin lesions. Early diagnosis and treatment with anti-tuberculosis drugs resolved skin issues but neurological deficits remained.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Neurology

Background:

  • Disseminated tuberculosis (TB) is rare in infants.
  • Tuberculosis can present with varied dermatological manifestations.
  • Neurological involvement in infant TB requires prompt recognition.

Observation:

  • A 4-month-old infant presented with horizontal nystagmus and multiform skin lesions.
  • Initial diagnosis of congenital nystagmus and staphylococcal infection was unresponsive to treatment.
  • Development of severe systemic symptoms prompted further investigation.

Findings:

  • Extensive investigations confirmed disseminated tuberculosis caused by Mycobacterium tuberculosis (MTB).
  • MTB was isolated from both skin lesions and cerebrospinal fluid.
  • Treatment included isoniazid, rifampicin, pyrazinamide, streptomycin, and dexamethasone.

Implications:

  • Early diagnosis of disseminated TB in infants is crucial.
  • Prompt anti-tuberculosis treatment can resolve cutaneous manifestations.
  • Severe neurological deficits may persist despite treatment, highlighting the impact of TB on infant neurodevelopment.

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