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Disseminated Tuberculosis Mimicking as Crohn's Disease in a Paediatric Patient

Elizabeth Feenstra1, Yentl Driesen2, Nicolette Moes1

  • 1Paediatric Department, Antwerp University Hospital (UZA), Edegem, Belgium.

Case Reports in Infectious Diseases
|July 10, 2023
PubMed

Insights

Pediatric tuberculosis can present with vague symptoms, mimicking other conditions like Crohn's disease. This case highlights the diagnostic challenges and the unexpected tuberculostatic effect of meropenem in a child with disseminated tuberculosis.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Tuberculosis (TB) remains a significant global health concern, particularly in pediatric populations.
  • Children often exhibit diverse clinical presentations of TB, frequently with nonspecific symptoms that can be misdiagnosed.
  • Disseminated tuberculosis involves multiple organ systems, complicating early and accurate diagnosis.

Observation:

  • A case study of an 11-year-old boy with disseminated tuberculosis involving intestinal and subsequent pulmonary manifestations is presented.
  • The initial clinical presentation mimicked Crohn's disease, leading to a diagnostic delay of several weeks.
  • Improvement of symptoms with meropenem further complicated the diagnostic process.

Findings:

  • Microscopic examination of gastrointestinal biopsies was crucial for identifying tuberculosis.
  • Meropenem demonstrated an unexpected tuberculostatic effect in this patient.
  • Diagnostic challenges in pediatric disseminated tuberculosis include nonspecific symptoms and misleading clinical pictures.

Implications:

  • Highlights the importance of considering tuberculosis in children presenting with gastrointestinal and pulmonary symptoms, even when mimicking other diseases.
  • Emphasizes the need for thorough histopathological examination of biopsies in suspected cases.
  • Suggests that the tuberculostatic properties of meropenem warrant further investigation and awareness among clinicians managing pediatric TB.

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