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Intestinal/Peritoneal tuberculosis in children: an analysis of autopsy cases

Cecilia Ridaura-Sanz1, Eduardo López-Corella, Ruy Lopez-Ridaura

  • 1Department of Pathology, National Institute of Pediatrics, 04530 Mexico City, DF, Mexico.

Tuberculosis Research and Treatment
|January 16, 2013
PubMed

Insights

Mycobacterium bovis infection, linked to unpasteurized milk, causes abdominal tuberculosis in children. Autopsies distinguished primary intestinal, secondary intestinal, and peritoneal tuberculosis, aiding diagnosis and prevention.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Pediatric Pathology

Background:

  • Tuberculosis (TB) caused by Mycobacterium bovis (M. bovis) is prevalent in Mexico, often linked to consuming unpasteurized milk products.
  • Abdominal tuberculosis encompasses peritoneal, primary intestinal, and secondary intestinal TB, posing diagnostic challenges due to overlapping clinical presentations.

Purpose of the Study:

  • To review clinical and pathological features of pediatric abdominal tuberculosis.
  • To differentiate primary intestinal TB, secondary intestinal TB, and peritoneal TB using postmortem analysis.
  • To inform diagnostic and preventive strategies for M. bovis infection in endemic regions.

Main Methods:

  • Retrospective review of 24 pediatric autopsy cases with abdominal tuberculosis at a Mexico City referral hospital.
  • Pathological examination to identify the type and extent of abdominal TB.
  • Molecular identification of M. bovis in relevant cases.

Main Results:

  • Eight cases of primary intestinal TB were identified, with M. bovis confirmed in six.
  • Nine cases of secondary intestinal TB (from primary pulmonary TB) were M. bovis negative.
  • Seven patients had peritoneal TB; four had concurrent active pulmonary TB, and three showed evidence of healed intestinal disease.

Conclusions:

  • Postmortem analysis effectively differentiated types of abdominal tuberculosis, including primary vs. secondary intestinal TB and peritoneal involvement.
  • Distinguishing these forms is crucial for targeted diagnostic approaches and public health interventions.
  • Understanding M. bovis transmission routes, like unpasteurized milk, is vital for TB control in endemic areas.

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