Peritoneal Tuberculosis in Infants: Diagnostic Challenges

Area of Science:

• Pediatrics
• Infectious Diseases
• Gastroenterology

Background:

• Abdominal tuberculosis is uncommon in immunocompetent infants, presenting diagnostic challenges.
• Peritoneal tuberculosis can mimic other pediatric surgical emergencies like intussusception.

Observation:

• Two infants (6 and 8 months) presented with symptoms suggestive of intussusception, leading to exploratory laparotomy.
• Intraoperative findings in the first infant revealed characteristic peritoneal tuberculosis lesions with granulations.

Findings:

• Histopathological examination confirmed peritoneal tuberculosis in both infants.
• The first infant had a positive Tuberculin intradermal reaction (IDRt) and positive tuberculous culture.
• The second infant had negative IDRt and GeneXpert tests, underscoring the need for histopathology.

Implications:

• This case series emphasizes the importance of considering abdominal tuberculosis in infants with unclear abdominal pathologies.
• Prompt diagnosis and initiation of tuberculostatic therapy led to favorable outcomes in both cases.
• Highlights the diagnostic utility of histopathology even with negative microbiological or rapid tests.