Disseminated extrapulmonary tuberculosis with abdominal and meningeal involvement in a pediatric patient: case report

Autores/as

DOI:

https://doi.org/10.37135/ee.04.27.07

Palabras clave:

Extrapulmonary tuberculosis, Gastrointestinal tuberculosis, Meningeal tuberculosis, Pediatrics

Resumen

Abdominal tuberculosis primarily affects the terminal ileum, cecum, and lymphoid-rich areas, manifesting with chronic abdominal pain, weight loss, persistent fever, exudative ascites, and altered bowel habits. The case of an adolescent with a one-month history of abdominal pain accompanied by joint pain, decreased appetite, fainting, weakness, and weight loss was presented. The patient was admitted to the operating room with a suspected acute abdomen, and surgical findings led to a suspicion of intra-abdominal tuberculosis, confirmed by GeneXpert and pathology results. She subsequently presented with clinical signs of meningeal tuberculosis, confirmed by laboratory testing. Peritoneal tuberculosis is uncommon in the pediatric population; Clinical manifestations are often chronic and unclear, leading to confusion with other abdominal pathologies.
A high index of suspicion is crucial for ordering the necessary tests to reach a diagnosis and initiate timely treatment.

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Referencias

Urteneche MI, González NE, Ginestet E, Macha Marín E, Pereda R, Pablo M, Cassanelli PM. Diagnosis of central nervous system tuberculosis in pediatric patients. Arch Argent Pediatr. 2025 [cited 8 Sep 2025];123(3):e202410592. Available on: https://www.researchgate.net/profile/Norma-Gonzalez-10/publication/390664511_Diagnosis_of_central_nervous_system_tuberculosis_in_pediatric_patients/links/68c037276f87c42f3b913486/Diagnosis-of-central-nervous-system-tuberculosis-in-pediatric-patients.pdf. DOI:10.5546/aap.2024-10592.eng. PMID:40202289.

Tobin EH, Khatri AM. Abdominal Tuberculosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 9 Sep 2025]. Available on: https://www.ncbi.nlm.nih.gov/books/NBK556115/

Smiles S, Stante C, Ruda M, Magnanelli V, Palmieri FI, Cheistwera A, Mirón L, Neyro S. Abdominal tuberculosis in pediatrics: a case report. Arch Argent Pediatr. 2024 [cited 10 Sep 2025];122(2):e202310049. Available on: https://www.sap.org.ar/storage/app/media/docs/publicaciones/archivosarg/2024/v122n2a05e.pdf. DOI:10.5546/aap.2023-10049.eng. Epub 2023 Oct 5. PMID:37725752.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004 [cited 8 Sep 2025];120(4):316-53. Available on: https://www.proquest.com/docview/195971009?pq-origsite=gscholar&fromopenview=true&sourcetype=Scholarly%20Journals. PMID: 15520485.

Maita Quispe F, Vargas J. Tuberculosis abdominal como causa de abdomen agudo: tuberculosis abdominal. Gac Med Boliv [Internet]. 2021 Jun 30 [cited 25 Nov 2025];44(1):96-8. Available on: https://www.gacetamedicaboliviana.com/index.php/gmb/article/view/110. doi:10.47993/gmb.v44i1.179.

Lancella L, Abate L, Cursi L, Chiopris G, Nicoletti L, Principi N, Villani A, Esposito S. Abdominal tuberculosis in children: a case series of five patients. Microorganisms. 2023 [cited 6 Nov 2025];11(3):730. Available on: https://www.mdpi.com/2076-2607/11/3/730. DOI:10.3390/microorganisms11030730.

Gleason JB, Tashtoush B, Mehta J, Savage E, Martinez F, Mehta AC. Pulmonary artery invasion caused by Mycobacterium tuberculosis. Chest. 2016 [cited 19 Sep 2025];150(4):e99-e103. Available on: https://www.sciencedirect.com/science/article/abs/pii/S0012369216415254. DOI:10.1016/j.chest.2016.02.655. PMID:27719830.

Aguado JM, Silva JT, Samanta P, Singh N. Tuberculosis and transplantation. Microbiol Spectr. 2016 [cited 20 Sep 2025];4(6). Available on: https://onlinelibrary.wiley.com/doi/abs/10.1128/9781555819866.ch36. DOI:10.1128/microbiolspec.TNMI7-0005-2016.

Lu MC, Lai CL, Tsai CC, Koo M, Lai NS. Increased risk of pulmonary and extrapulmonary tuberculosis in patients with rheumatic diseases. Int J Tuberc Lung Dis. 2015 [cited 21 Sep 2025];19(12):1500-6. Available on: https://europepmc.org/article/med/26614192.

DOI:10.5588/ijtld.15.0087. PMID:26614192.

Rodríguez-Takeuchi SY, Renjifo ME, Medina FJ. Extrapulmonary tuberculosis: pathophysiology and imaging findings. Radiographics. 2019 [cited 24 Sep 2025];39(7):2023-37. Available on: https://pubs.rsna.org/doi/abs/10.1148/rg.2019190109. DOI:10.1148/rg.2019190109.

Yang A, Shi J, Luo Y, Ye Y, Tan Y, Huang H, Zhao Y. Allo-HSCT recipients with invasive fungal disease and ongoing immunosuppression have a high risk for developing tuberculosis. Sci Rep. 2019 [cited 26 Sep 2025];9(1):20402. Available on: https://www.nature.com/articles/s41598-019-56013-w. DOI:10.1038/s41598-019-56013-w. PMID:31892702; PMCID:PMC6938515.

Kang W, Yu J, Du J, et al. The epidemiology of extrapulmonary tuberculosis in China: a large-scale multi-center observational study. PLoS One. 2020 [cited 27 Sep 2025];15(8):e0237753. Available on: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237753. DOI:10.1371/journal.pone.0237753. PMID:32822367; PMCID:PMC7446809.

Tahseen S, Khanzada FM, Baloch AQ, Abbas Q, Bhutto MM, Alizai AW, Zaman S, Qasim Z, Durrani MN, Farough MK, Ambreen A, Safdar N, Mustafa T. Extrapulmonary tuberculosis in Pakistan–A nation-wide multicenter retrospective study. PLoS One. 2020 [cited 28 Sep 2025];15(4):e0232134. Available on: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232134. DOI:10.1371/journal.pone.0232134. PMID:32343714; PMCID:PMC7188211.

Alemu A, Yesuf A, Gebrehanna E, Zerihun B, Getu M, Worku T, Bitew ZW. Incidence and predictors of extrapulmonary tuberculosis among people living with Human Immunodeficiency Virus in Addis Ababa, Ethiopia: a retrospective cohort study. PLoS One. 2020 [cited 29 Sep 2025];15(5):e0232426. Available on: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232426. DOI:10.1371/journal.pone.0232426. PMID:32374773; PMCID:PMC7202654.

Arpagaus A, Franzeck FC, Sikalengo G, Ndege R, Mnzava D, Rohacek M, Hella J, Reither K, Battegay M, Glass TR, Paris DH, Bani F, Rajab ON, Weisser M; KIULARCO Study Group. Extrapulmonary tuberculosis in HIV-infected patients in rural Tanzania: the prospective Kilombero and Ulanga antiretroviral cohort. PLoS One. 2020 [cited 8 Nov 2025];15(3):e0229875. Available on: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0229875. DOI:10.1371/journal.pone.0229875. PMID:32130279; PMCID:PMC7055864.

Hayward SE, Rustage K, Nellums LB, van der Werf MJ, Noori T, Boccia D, Friedland JS, Hargreaves S. Extrapulmonary tuberculosis among migrants in Europe, 1995 to 2017. Clin Microbiol Infect. 2021 [cited 10 Nov 2025];27(9):1347.e1-1347.e7. Available on: https://www.sciencedirect.com/science/article/pii/S1198743X20307618. DOI: 10.1016/j.cmi.2020.12.006. Epub 2020 Dec 19. PMID: 33352301; PMCID: PMC8437049.

Chu P, Chang Y, Zhang X, Han S, Jin Y, Yu Y, Yang Y, Feng G, Wang X, Shen Y, Ni X, Guo Y, Lu J; Futang Research Center of and Pediatric Development (FRCPD). Epidemiology of extrapulmonary tuberculosis among pediatric inpatients in mainland China: a descriptive, multicenter study. Emerg Microbes Infect. 2022 [cited 12 Nov 2025];11(1):1090-1102. Available on: https://www.tandfonline.com/doi/full/10.1080/22221751.2022.2054367. DOI:10.1080/22221751.2022.2054367. PMID:35290153; PMCID:PMC9009909.

Jeong YJ, Kang JY, Kim HW, Min J, Ko Y, Oh JY, Kang HH, Lim SC, Hwang HG, Shin KC, Lee HB, Kim JS, Park JS, Lee SS, Koo HK. Association of underlying comorbidities and sites of tuberculosis: an analysis using surveillance data. BMC Pulm Med. 2022 [cited 12 Nov 2025];22(1):417. Available on: https://link.springer.com/article/10.1186/s12890-022-02224-3. DOI:10.1186/s12890-022-02224-3. PMID:36371212; PMCID:PMC9652946.

Jarde A, Romano E, Afaq S, Elsony A, Lin Y, Huque R, Elsey H, Siddiqi K, Stubbs B, Siddiqi N. Prevalence and risks of tuberculosis multimorbidity in low‑income and middle‑income countries: a meta‑review. BMJ Open. 2022 [cited 15 Nov 2025];12(9):e060906. Available on: https://bmjopen.bmj.com/content/12/9/e060906.abstract. DOI:10.1136/bmjopen‑2022‑060906. PMID:36175100; PMCID:PMC9528681.

Li T, Yan X, Du X, Huang F, Wang N, Ni N, Ren J, Zhao Y, Jia Z. Extrapulmonary tuberculosis in China: a national survey. Int J Infect Dis. 2023 [cited 16 Nov 2025];128:69-77. Available on: https://www.sciencedirect.com/science/article/pii/S1201971222006452. DOI:10.1016/j.ijid.2022.12.005. Epub 2022 Dec 10. PMID:36509333.

Mahomed N, Kilborn T, Smit EJ, Chu WCW, Young CYM, Koranteng N, Kasznia-Brown J, Winant AJ, Lee EY, Sodhi KS. Tuberculosis revisited: classic imaging findings in childhood. Pediatr Radiol. 2023 [cited 23 Nov 2025];53(9):1799-1828. Available on: https://link.springer.com/article/10.1007/s00247-023-05648-z. DOI:10.1007/s00247-023-05648-z. Epub 2023 May 23. PMID:37217783; PMCID:PMC10421797.

Niu T, He F, Yang J, Ma C, Xu J, Sun T, Zhang X, Chen S, Ru C. The epidemiological characteristics and infection risk factors for extrapulmonary tuberculosis in patients hospitalized with pulmonary tuberculosis infection in China from 2017 to 2021. BMC Infect Dis. 2023 [cited 29 Nov 2025];23(1):488. Available on: https://link.springer.com/article/10.1186/s12879-023-08410-w. DOI:10.1186/s12879-023-08410-w.

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Publicado

2026-09-30

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Cómo citar

1.
Verdezoto Unda SD, Vaca Salazar CF, Avalos Trujillo VA, Gómez Mafla MA. Disseminated extrapulmonary tuberculosis with abdominal and meningeal involvement in a pediatric patient: case report. REE [Internet]. 2026 Sep. 30 [cited 2026 Sep. 30];20(3):107-1. Available from: https://eugenioespejo.unach.edu.ec/index.php/EE/article/view/1100

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